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LIBRARY OF CONGRESS. 
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UNITED STATES OF iERICA. 



THE 



PRE SCRIBER'S 



MEMORANDA 



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V 




NEW YORK 
WILLIAM WOOD & COMPANY 

1881 



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Copyright by 
WILLIAM WOOD & CO. 

1881. 



Trow's 

Printing and Bookbinding Company 

201-213 East 1.1th Street 

NEW YORK 



PRESCRIBED MEMORANDA. 



ABORTION. 

Dr. Wm. T. Lusk gives the following rules 
for the treatment of abortion : 

1. In the first two months an abortion needs 
no special treatment. The hemorrhages of 
early date are amenable to the same principles of 
treatment as those from a non-pregnant uterus. 

2. In the third month no treatment is re- 
quired when the ovum is expelled with intact 
membranes. 

When the membranes rupture previous to ex- 
pulsion, and hemorrhage takes place, immediate 
removal should be attempted, provided the cer- 
vix be sufficiently dilated to admit the index 
finger. When the cervix is closed the tampon 
should be tried for twenty-four hours. If the 
tampon proves ineffective, the cervix should 
then be dilated with a sponge-tent, and the 
ovum removed with the finger. The finger 



2 PRESCRIBES S MEMORANDA. 

should pass up along the side of the uterus, 
across the fundus, and complete the circuit of 
the uterine cavity. 

3. In cases of neglected abortion, retained 
portions should be removed by the finger or the 
curette. When the ovum is decomposed, no 
dilation of the os is usually necessary. When 
the ovum is fresh, the preliminary use of sponge- 
tents is usually demanded if manual delivery is 
resorted to. 

4. In immature deliveries, hemorrhage can 
usually be controlled without the tampon, by 
compression of the uterus, and in cases of de- 
lay, by the manual extraction of the placenta. 

Dr. Fordyce Barker says : Abortions occurring 
within the second month ordinarily require but 
little treatment. But I have seen patients who 
were perfectly exsanguinated by a hemorrhage 
which occurred within the eighth week of preg- 
nancy. Yet these cases are rare. I saw one 
patient who had passed only one menstrual 
period when she suddenly found herself flowing, 
and soon became so completely exsanguinated 
that it seemed almost hopeless to attempt to 
save her life. In early embryonic abortions, 
manipulations within the uterine cavity, for the 
removal of the ovum, are not practicable, be- 
cause the uterus is not yet sufficiently devel- 



prescreber's memoranda. 3 

oped. In early abortions attended by profuse 
hemorrhage, I am accustomed to place the pa- 
tient crosswise in bed, with the hips drawn well 
over the edge of the bed, the legs flexed, and the 
thighs held at right angles to the body ; then 
place a rubber sheet under the patient, so as to 
protect the clothing and the bed perfectly, and 
conduct the water to run into a pail below, and 
then inject into the vagina a large quantity of 
very hot water, from 104° F. to 110° F. I be- 
lieve that one may always be sure that this will 
positively, absolutely, and efficiently arrest the 
hemorrhage. In all the cases where I have re- 
sorted to this method I have never found it ne- 
cessary afterward to subject the patient to 
manipulations for removal of the ovum. It has 
always come away spontaneously — sometimes 
the next day, or the next day but one — and 
absolutely without hemorrhage. 

In cases of abortion, when I find it necessary 
to tampon, I never trust to any kind of vaginal 
tampon, but always tampon the cervix uteri 
with a compressed sponge of proper size, and 
then fill the vagina only just sufficient to keep 
the sponge in place. This, if properly done, is 
certain to arrest the hemorrhage, and, in from 
eight to twelve hours, during which the patient 
rallies from the dangerous exhaustion following 



4 PRESCRIBES S MEMORANDA. 

the loss of blood, the cervix is sufficiently dilated 
to permit the safe removal of the entire ovum 
with the finger. 



ALCOHOLISM. 

Br. F. P. Atkinson says : There are three 
different stages in the disease : 

1st. Sleeplessness, accompanied by a hard, 
quick pulse ; loss of appetite in the morning, 
and morning sickness. 

^ . Tinct. rhei Tft x. 

Tinct. card, co 3 ss. 

Tinct. hyoscyami 3 ss. 

Acid, hydrocyanic, dil 1TI_ iij. 

Spts. chlorof ormi TT\_ xv. 

Aquse ad. § j. 

S. — To be taken every four hours. 

The prussic acid acts as a sedative to the 
stomach, heart, and brain. The hyoscyamus 
has also to a certain extent the same effect. 

Abstinence from stimulants in this, as in the 
other stages, is strictly enjoined ; but, when I 
find it difficult to get this carried out, I allow a 
glass of claret three times a day. It is essen- 
tial that the patient have plenty of light and 
easily digestible food, and with this object I or- 



PRESCRIBES S MEMORANDA. O 

der essence of beef, milk and eggs beaten up to- 
gether and barley-water. This diet is suitable 
to each stage. The only thing to be said is, the 
more the depression the more the nourishment. 

2d. Drowsiness, accompanied by a slow, some- 
what comprehensible and excitable pulse, com- 
plete loss of appetite, and constant sickness. 
The blood has in it an excessive amount of 
hydrocarbon. 

The treatment should be the same as just 
described, only it is as well to omit the prus- 
sic acid, as there is not the same excitement 
present. 

3d. Delirium, accompanied by complete ab- 
sence of sleep and the presence of horrible appa- 
ritions, especially at night. The pulse is small, 
quick, easily excitable, and compressible. The 
blood is deficient in red corpuscles. Hydrocar- 
bons are present in poisonous quantities ; the 
brain undergoes little or no repair. The vaso- 
motor nerve-influence is almost entirely lost. 
The treatment I have found beneficial in each 
stage is the following : 

Chloral should be given in thirty-grain doses 
every four hours, till sleep comes on, and then be 
repeated as often as necessary. The nourish- 
ment should by no means be forgotten, and 
stimulants should be strictly forbidden. 



6 pkescbibee's memokanda. 

If chloral is continued beyond a certain time, 
a sleepless condition recurs, when nux vomica 
and gentian should be given as follows : 

I£ . Tinct. nucis vomicae Tft x. 

Tinct. gent, co 3 ss. 

Ess. limonis Tf^ j. 

Spts. chlorof ormi KI^ xv. 

Aquse ad. § j. 

S. — To be taken three or four times a day. 

This rarely fails to reindu.ce sleep, but, if per- 
sisted in long after it has produced its effects, 
sleeplessness returns. When this is the case, the 
tincture of gentian, columbo, or chiretta, should 
be given alone. 

Dr. G. D. Griffith says that an entirely new 
series of symptoms result from the prolonged 
use of chloral for alcoholism. His observations 
would indicate that the drug may produce a 
condition akin to that for the cure of which it 
is given. 

Dr. Luton is strongly in favor of a more gen- 
eral use of strychnine in alcoholism, and believes 
it is given, at present, with too much timidity. 
In delirium tremens, hypodermic injections of 
strychnine may be continued almost to the com- 
mencement of tetanic action. In imminent 
alcoholism a few drops of the tincture of nux 



prescriber's memoranda. 7 

vomica may be given at the beginning of 
meals. 

Dr. d'Ancona, of Italy, gives gr. jss. of zinc 
phosphide (in divided doses) daily, for many 
weeks, with decided benefit to drinkers. 



$. Tinct. gent, co., 

Tinct. calumbas co aa 3 j. 

Tinct. nucis vom gtts. v.-xv. 

M. To be taken before meals. 

For rum stomachs. Loomis. 



Oxide of zinc, in doses of from three to five 
grains, twice or three times a day, has produced 
good results in chronic alcoholism. 



The tincture of digitalis, in teaspoonful doses 
every two, three, or four hours, has cured many 
cases of delirium tremens promptly, and with- 
out producing any unfavorable symptoms. 



ANiEMIA, Mixtures for. 

Dr. Wm. Goodell says : 

Basham's iron mixture, with the addition of 
fractional doses of strychnia, will be found very 



© PKESCRIBEKS MEMOKANDA. 

admirable in its effects. There are so many 
indifferent recipes for making this celebrated 
mixture, that I shall here give the one which 
seems to be the best : 

^ . Tinct. ferri chlor fl. 3 iij. 

Acid. acet. dil fl. | ss. 

Liq. ammonias acetat fl. | iijss. 

Curacose, 

Syr. simplicis aa fl. 3 j. 

Aquae ad. fl. % viij. 

M. S. — One tablespoonf ul after each meal. 

The following formula makes another very 
elegant and generally useful preparation of 
iron : 

IJ • Tinct. ferri chlor fl. 3 ij. 

Acid, phosphor, dil fl. 3 iij. 

Spts. limonis fl. 3 j. 

Syr. simplicis fl. § ijss. 

Aquas ad. fl. § vj. 

M. S. — One tablespoonf ul after each meal. 

The dilute phosphoric acid is added, both be- 
cause it is a valuable nerve-tonic and because 
it has the property of disguising the styptic 
taste of the iron — so much so that children 
readily take this mixture. 



pkesceibek's memokanda. 9 

There are two other tonic preparations which 
are prescribed very frequently in the Hospital of 
the University of Pennsylvania, and with excel- 
lent results. One of them is Blaud's pill, which 
Niemeyer extols so very highly : 

I£. Pulv. ferri sulph. exsiccata, 

Potass, carb. puras aa 3 ij. 

Syrupi q. s. 

M. Divide into pills no. xlviij. 

During the first three days one pill is to be 
taken after each meal. On the fourth day four 
pills are taken during the day, on the fifth day 
five pills ; on the sixth day six — that is to say, 
two pills after each meal. For three days more 
six pills are taken daily ; then the dose is to be 
increased by one pill daily until three pills are 
taken after each meal. On this final dose the 
patient is kept for three or four weeks, as the 
case may be. In stubborn cases I have occa- 
sionally increased the dose to the number of five 
pills thrice daily, and have seen no other bad 
effects from it than a feeling of fulness in the 
head. This immunity is probably owing to the 
conversion of the iron sulphate into a carbonate. 

The other preparation is a valuable alterative 
tonic, for the formula of which I am indebted 
to my friend, Dr. A. H. Smith : 



10 prescriber's memoranda. 

I}. Hydrarg. chlor. corros gr. i-ij. 

Liq. arsenici chlor fl. § j. 

Tinct. f erri chlor. , 

Acid, hydrochlor. dil aa fl. 3 iv. 

Syr fl. § iij. 

Aquae ad. fl. 5 vj. 

M. S. — One dessertspoonful in a wineglass- 
ful of water, after each meal. 

Anaemic and chlorotic patients will fatten and 
thrive wonderfully on this mixture. I call it 
the Mixture of Four Chlorides. It should not 
be given for a longer period than two weeks at 
a time. 

To counteract the possible costive effect of 
sulphate of iron, this aperient mixture is given : 
1$, . Pulv. glycyrrhizse rad. , 

Pulv. sennse aa § ss. 

Sulphuris sublim., 

Pulv. fceniculi aa 3 ij. 

Sacchar. purif 3 3 SS * 

M. S. — One teaspoonful in half a cupful of 
water at bed- time. 

Where the disease is due to torpidity of the 
ovaries, this prescription is used : 

$ . Ext. aloes 3 J. 

Ferri sulph. exsiccata 3 ij. 

Asaf cetidee 3 iv. 



prescriber's memoranda. 11 

M. S. — One pill after each meal. This 
number to be gradually increased to two, and 
then to three pills, after each meal. If the 
bowels are at any time over-affected, return to 
the initial dose of one pill after each meal. 



Ancemia (iron and oxygen in). — Dr. Hay em, 
in conjunction with M. Begnauld, has made 
a number of observations on this subject. It 
was found that the administration of iron, in 
the form of Berlin blue, had no effect in im- 
proving the state of the blood or the appetite 
of the patients, unless inhalations of oxygen 
were also employed. They found that, if the 
inhalations of oxygen were desisted from, the 
patient 1 s condition retrograded, though it had 
been apparently improved ; while the simulta- 
taneous use of iron and oxygen produced a per- 
manent improvement, the red corpuscles being 
increased both in quality and in quantity. They 
arrive at the following conclusions : 1. The ac- 
tive preparations of iron act as a blood-pre- 
paring material, contributing especially to the 
formation of the red corpuscles ; 2. Iron does 
not always act alone, but in dyspeptic subjects 
inhalations of oxygen are also necessary, in 
order to completely subdue the chlorosis and 
anaemia. 



12 presceibek's memokanda. 

]> . Tinct. f erri chlor. , 

Acid, phosphor, dil aa fl. 3 j. 

Syrupi fl. 3 vj. 

M. Dose, a teaspoonful. 

I£ . Tinct. f erri chlor TT^ xx. 

Acid. acet. dil 7T^ xx. 

Liq. amnion, acet. . . . q. s. ad. fl. 3 j. 
jVI. Dose, two to four teaspoonfuls. 

T? . Ferri sulph gr. ij . 

Magnesii sulphatis . I jss. 

Acid, sulph. dil. Ti\_ xv. 

Infus. quassias q. s. ad. fl. ? j. 

M. Dose, a teaspoonful. 



The following tonic pills are much prescribed 
at the Gynecological Clinic of the Hospital of 
the University of Pennsylvania : 

3 . Acid arseniosi, 

Strychnine sulph a a gr. j.-xxxv. 

Ext. belladonna gr. j.-v. 

Cinchonise sulph gr. jss. 

Pil. ferri carb. gr. ijss. 

M. et ft. pil. no. j. 



prescriber's memoranda. 13 

5 . Acid, arseniosi gr. j.-xxxv. 

Cinchoniae sulph gr. jss. 

Ferri et potass, tart gr. ij. 

M. et ft. pil. no. j. 

The sulphate of cinchona in these pills may 
be advantageously substituted by a proportion- 
ate dose of sulphate of quinia, the former being 
used simply on account of its cheapness. One 
pill may be given after each meal. 



3 . Vini ferri fl. 3 iij. 

Liq. potassii arsenitis, 

Syrupi aa fl. 3 ss. 

Aquae fl. 3 ss. 

M. Dose, one teaspoonful, diluted, after 
meals. In general anaemia and anaemia of 
nursing women. Best given in cod-liver oil. 



Injections of Ether and Brandy in the Acute 
Anaemia of Parturient Women. — In cases of vi- 
cious insertion of the placenta, when it pro- 
duces such an abundant hemorrhage that the 
woman is exsanguinated, and it becomes neces- 
sary at once to raise the temperature and stimu- 
late the nervous centres, M. Chantreuil advises 
the injection of sulphuric ether (4 grammes = 
| j. for example) into the subcutaneous cellular 



14 pbesceibee's memoeanda. 

tissue. A little later we may use one or more 
similar injections of cognac. Under their influ- 
ence the faintings cease, the heat is re-estab- 
lished and the patient is reanimated. In this 
way, if transfusion becomes indispensable, we 
have at least gained time. . 



Hypodermic injections of brandy or whiskey, 
in half-teaspoonful or teaspoonful doses, re- 
peated every fifteen or twenty minutes in the 
acute anosmia caused by loss of blood, as in flood- 
ing or severe surgical operations, are of the 
greatest service, and sometimes become the 
chief reliance of the xDhysician. 



The following tonic mixtures are used in 
public institutions in New York City : 

1} . Ext. cinchonise fl fl. 3 j. 

Ferri et ammonii cit 3 ij. 

Spts. aurantii (1:10) fl. § 3. 

Alcoholis fl. 3 iv. 

01. cinnamomi TT^ xv. 

Aquae fl. 3 vj. 

Syrupi q. s. ad. fl. ? xvj. 

With the oil of cinnamon and water make 
water of cinnamon ; dissolve in this the ammo- 
nio-citrate of iron ; add the spirits of orange and 
the fluid extract of cinchona. Filter, and add 



prescreber's memoranda. 15 

enough syrup to make the product measure 
one pint. Dose, a teaspoonful. 

5 . Tinct. ferri. chlor fl. 3 ij. 

Aquas fl. 3 ij. 

# . Cinchonias sulph gr. xxv. 

Acid, sulph. dil q. s. 

Aquae , fl. § 3, 

Acid, citr 3 ss. 

Syrupi fl. I jss. 

Tinct. ferri chlor fl. 3 ss. 

Aquas q. s. ad. fl. 3 iv. 

M. Dose, a teaspoonful. 

I£ . Sol. cinchon. sulph. (30 grs. 

infl-lj.) A-3J- 

Acid, citr 3 ss. 

Syrupi fl. 3 jss. 

Tinct. ferri chlor fl. 3 ss. 

Aquas. . ., q. s. ad. fl. § iv. 

M. Dose, a teaspoonful. 

]£ . Quinias sulph gr. xxv. 

Acid, sulph. dil q. s. 

Aquas fl. 3 ij. 

Tinct. ferri chlor fl. 3 ss. 

Spts. chloroformi fl. 3 vj. 

Glycerinas .q. s. ad. fl. 3 iv. 

M. Dose, a teaspoonful. Loomis. 



16 prescriber's memoranda. 

]£. Sol. quiniae sulph. (15 grs. in 

fl.lj.) fkjfl. 

Tinct. ferri chlor fl. 5 ss. 

Spts. chloroformi fl. 3 vj. 

Loomis. 

3 . Ferri ammon. cit 3 j. 

Amnion, carb gr. xxx. 

Tinct. gent, co., 

Tinct. quassias aa fl. 3 ij. 

Syrupi fl. 5 jss. 

Aquae q. s. ad. fl. § viij. 

M. Dose, a dessertspoonful. Thomson. 

3£ . Acid, muriat fl. 3 iij. 

Tinct. gent. co. , 

Aquae aa fl. § viij. 

M. Dose, a teaspoonful. 

^ . Cinchoniae sulph 3 j- 

Acid, sulph. dil q. s. 

Aquae fl. % iv. 

M. Dose, a teaspoonful. 

Griffith's Mixture. 

Tfr . Cinchoniae sulph 3 j. 

Acid, sulph. dil q. s. 



prescriber's memoranda. 17 

^ . Ferri sulph gr. xx. 

Potassii carbon gr. xxv. 

Pulv. myrrhaB, 

Pulv. sacchari aa 3 j. 

Spts. lavand co 11. § ss. 

Aquae cirmamom q. s. ad. fl. 3 viij. 

M. Dose, half a tablespoonful. In preparing 
this, the sulphate of iron, dissolved in one-half 
fluid ounce of the cinnamon water, should be 
added last. The mixture should be made fresh, 
when needed. 



$. Ferri et ammon. cit., 

Ammonii carbon aa gr. xxxij. 

Syrupi, 

Aquae anisi aa fl. § ij. 

M. Dose, a teaspoonful. J. L. Smith. 



I£. Sol. cinchoniaa sulph. (30 grs. 

infl-|j.) A- 3 ij- 

Tinct. ferri chlor fl. 3 ij 

M. Dose, a teaspoonful. 

3 . Ferri et potass, tart 3 j. 

Tinct. cinch, co fl. 5 iv. 

M. Dose, a teaspoonful. 



18 prescribes' s memoranda. 

]$ . Cinchonise sulph 3 j. 

Tinct. ferri chlor fl. 3 ij. 

Aquas q. s. ad. fl. § iv. 

M. Dose, a teaspoonful. 

I£ . Quiniaa sulph gr. xxx. 

Acid, sulph. dil q. s. 

Aquae fl. § ij. 

Tinct. ferri chlor fl. 3 ij. 

Or, 

Sol. quinise sulph. (15 grs. in 

fl-ii-).. |L 

Tiuct. ferri chlor fl. 3 ij. 

M. Dose, a teaspoonful. 

B . Potassii iodidi e . . 3 iv. 

Syr. ferri iodidi fl. § j- 

Tinct. calumbae q. s. ad. fl. J iv. 

M. Dose, a teaspoonful. 

1$. Strychnise acet gr. j. 

Tinct. cardam. co fl. 3 ss. 

Alcoholis, 

Aquae aa fl. 3 ijss. 

Syrupi q. s. ad. fl. § iv. 

M. Dose, a teaspoonful. 



pkescribeb's memoranda. 19 

If. Tinct. cinch, co., 

Tinct. gant. co aa fl. 3 j. 

M. Dose, a teaspoonful. 



^ . Tinct. ferri chlor., 

Tincfc. nucis vom aa TT[_x. 

Aquas q. s. ad. fl. 3 j. 

M. One dose. To be taken thrice daily, 
after meals. 



Syr. Calcis Lacto-phosphatis is a solution of 
calcium phosphate in lactic acid and syrup, 
and contains in one fluid ounce : 

Calcium phosphate gr. xvj. 

Lactic acid gr. xxxiij. 

Syr. Ferri Quin. et Strych. Phospli. contains 
in one fluid drachm : 

Phosphate of iron gr. ij. 

Quinia gr. j. 

Strychnia gr- A- 

Wine of Iron, Beef, and Cinchona represents 
in one fluid ounce : 

Cinchona bark gr. xxxij. 

Extract of beef (Liebig's) .... gr. xvj. 

Pyrophosphate of iron gr. \iij. 

Dose, a teaspoonful. 



20 peesceibee's memoeanda. 

I}. Ferri et ammonii cit gr. xx. 

Viiii xerici fl. ij. 

M. Dose, a teaspoonful. 

$ . Ferri et quiniae cit % j. 

Vini xerici fl. § ij. 

M. Dose, a teaspoonful. 



Vy. . Ferri et quinidiae cit 3 j. 

Vini xerici fl. § ij. 

M. Dose, a teaspoonful. 

1$. Tinct. ferri chlor., 

Syrupi aa fl. § iv. 

Aqua3 fl. 1 viij. 

M. Dose, a teaspoonful. 



^ . Quiniae sulph , 3 j. 

Ferri redacti 3 jss. 

Acid, arseniosi, 

Strychniae aa gr. 3 iij. 

Conf ect. rosae q. s. 

M. Divide into 60 pills. Winslow. 



pkescriber's memoranda. 21 

ANAESTHESIA, Local. 

Take pounded ice or snow, and 
Common salt equal parts. 

Put both on a soft rag (musquito netting) ; mix 
it to form a kind of poultice and press it quickly 
against the skin where you intend to make an 
incision. In a very short time the skin freezes 
and becomes absolutely insensible and bloodless. 
As to the length of time this state of the skin 
may be maintained without endangering its 
vitality, it may be continued sufficiently long 
for the performance of any minor operation. 

As the temperature begins sinking the mo- 
ment the ice and the salt are brought in con- 
tact, all that is necessary for the performance 
of the operation must be ready before making 
the mixture. Special care must be taken to 
have the knife as sharp as possible, for the fro- 
zen skin is remarkably tough, and resists the 
instrument to a high degree. 



ANOREXIA, Mixtures for. 

Tinct. of nucis vomica? gtt. v. 

Ext. of gent gr. xv. 

Syr. aurantii cort 3 jss. 

Quinine wine 3 ivss. 



22 pkescribek's memoranda. 

Make a solution. One-half to be taken half 
an hour before each of the two principal meals. 
In atonic dyspepsia. 



MUlii^s Carminative Elixir. 

I£ . Ginger J ss. 

Cinnamon, 

Long pepper aa 3 ij. 

Galanga, 

Nutmeg, 

Cloves aa 3 j. 

Cardamom 3 j. 

Alcohol 1 vj. 

M. Digest for fourteen days and filter. 
Dose : one to four teaspoonf uls in some suit- 
able vehicle. In atonic dyspepsia and flatu- 
lence. 

5 . Anthemidis, 

Quassise aa 3 j. 

M. et ft. chart, no. 1. S. — Put in a pint 
of boiling water, and when cold strain ; take a 
wineglassful three times a day, before meals. 
As an appetizer. 

IjS, . Gentianse, 
Quassias, 
Cinnamomi aa 3 ij. 



prescriber's memoranda. 23 

M. S. — Put in a pint of boiling water, and 
when cold strain ; take a wineglassful three 
times a day. An appetizer. 



^ . Calumbse, 

Zingiberis aa 3 ss. 

Sennas 3 ij. 

M. et ft. chart, no. 1. B. — Put in a pint 
of boiling water, and when cold strain ; take a 
wineglassful three times a day. An appetizer. 



ANTISEPTIC SOLUTION AND OINT- 
MENT, Lister's. 

To thirty ounces of water add one ounce and 
a half of crystallized carbolic acid. This gives 
a solution of the strength of one part of carbolic 
acid to twenty of water. This is for washing 
out the wound, washing the surgeon's hands, 
for dressing the wound, and for spraying the 
wound during the operation or redressing. 

Dilute this solution with equal parts of water, 
or make one of half the strength, and you. have 
a solution of the strength of one to forty. This 
is for the sponges, instruments, etc. 



24 prescrtber's memoranda. 

The articles necessary for operations or dress- 
ings are : 

{a). A steam -spray producer ; 

(b). A solution of carbolic acid (1 — 20) ; 

(c). A solution of carbolic acid (1 — 40) ; 

(d). Antiseptic gauze; 

(e). Apiece of Mackintosh cloth or rubber tissue ; 

(/). Drainage-tubes — a piece of soft catheter 

will answer ; 

(g). Carbolized oil-silk ; 

(7i). Bandages of antiseptic gauze ; 

(i). Catgut ligatures ; 

(j). Carbolized wax ligatures. 

All arteries should be tied with carbolized 
catgut ligature, and cut off short in the wound. 
The wound being thoroughly cleansed, a drain- 
age-tube with holes cut in the sides is passed 
through the wound, the parts brought together 
and secured by carbolized catgut or silk suture. 
Over the wound place a piece of carbolized oil- 
silk, dipped freshly in the 1 — 40 solution ; over 
this place two layers of prepared gauze, dipped 
in the 1 — 40 solution. On this place six or 
eight layers of the gauze, a piece of Mackin- 
tosh cloth being placed with the smooth sur- 
face down, between the superficial and the next- 
layer of gauze. The parts for a distance above 



prescriber's memoranda. 25 

and below the wound are to be bandaged with 
rollers of antiseptic gauze. This dressing is not 
to be changed unless the patient has high fever 
coming on after the operation, or the discharge 
from the wound soaks through the dressing. 
As often as the discharge wets through the 
dressings, so often should the dressing be re- 
moved. All dressings should be made under the 
carbolic spray. 

Care must be taken, during an operation, 
that the ether does not take fire from the flame 
of the atomizer spirit-lamp. The flame. should 
be protected by gauze. — Little. 



$. Acid, borac. pulv., 

Cerse albae aa 1 part. 

Olei amygdal. expr. , 

Paraffini aa 2 parts. 

Rub the almond oil with the boracic acid to 
a smooth mass in a warm mortar ; then add the 
melted wax and paraffin, and triturate until 
cold. — Lister. 



ASPHYXIA. 

Asphyxia in Children — Harvey Byrd's Method 
of Artificial Respiration. — Bring the ulnar sides 
of the hands near together and with the pal- 



26 pkesceiber's memoranda. 

mar surfaces looking vertically, and place them 
beneath the back of the infant, so that the ex- 
tended thumbs may aid, as far as possible, in 
sustaining the vertex and inferior extremities ; 
then, keeping the ulnar borders near together, 
so as to form a fulcrum, the radial borders or 
sides are simultaneously depressed to as great 
extent as practical — say forty-five degrees — be- 
low the horizontal line, and then gradually pro- 
nated or elevated to as many degrees above that 
line, thus facilitating the escape of air drawn 
into the lungs during the downward movement 
of the head and chest. Or the hands are placed 
as at first, and passed beneath the body of the 
child — on its back — and the superior and in- 
ferior extremities farthest from the operator 
seized, one by each hand, near the trunk, the 
ulnar borders of the hands and wrists forming 
the fulcrum — the head of the child being kept 
at a proper axis with the movements of the 
chest by the hands of an assistant, and the de- 
pression and elevation of the head and lower 
extremities proceeded with as already described. 
These alternate depressions and elevations of 
the two extremities, performed in a regular and 
gentle manner, and repeated at proper intervals, 
seldom fail in establishing respiration where it 
is possible of accomplishment. The cccasional 



pkescriber's memoranda. 27 

dashing of cold water on the epigastrium, during 
the descent of the head and chest, will hasten 
respiration where the first few movements fail 
in its establishment. It is important that the 
head be kept, as far as practicable, from too 
much lateral movement, and not permitted to 
depart considerably from its antero-posterior axis 
with the vertebral column during the continu- 
ance of the process. To this end, in a critical 
case, the hands of an assistant may be brought 
into requisition. The importance of these re- 
marks will be apparent to intelligent readers 
on a moment's reflection. No impediment 
should be permitted in the way of free entrance 
of air into the lungs during the downward 
movement of the head ; and it is scarcely less 
important that no obstruction should oppose the 
escape of air during the upward movement of 
the head and chest. 

Dr. W. E. Forests Method of Artificial Respi- 
ration for the Asphyxiated New-born. — Place the 
child in the sitting posture in a pail or tub con- 
taining sufficient water to cover the lower ex- 
tremities and reach upward on the body nearly 
to the free border of the ribs, and having a 
temperature of 104°-110° F. Place the right 
hand behind the head and thorax of the child 
and allow its body to lean backward so as to 



28 prescriber's memoranda. 

rest upon the hand. Carry the child's hands 
as far above its head as possible with your left 
hand. By this movement the ribs and shoulders 
are raised, while the head is thrown backward^ 
the thorax expands and air is drawn into the 
lungs. 

The second movement is to lower the arms of 
the child so that they fall by its side, while 
your hand, still retaining- those of the child in its 
grasp, rests upon the front of the child's thorax. 

The third movement is to lean the child for- 
ward, press suddenly downward upon its shoul- 
ders, and at the same time press the ribs inward 
with the hand in front. 

Dr. Wm. M. Polk says : 

" Catheterism of the larynx as a means of re- 
suscitating the asphyxiated has been suggested 
from time to time, but I know of no case estab- 
lishing its superiority so entirely as that which 
I report here [The Medical Record, vol. xvii. , 
p. 709] . With a stiff instrument the procedure 
is so simple, and so much more certain than all 
other methods of exciting respiration, that it 
seems to me it should be given more prominence 
than it has hitherto enjoyed. The condition 
that exists in actnal or impending asphyxia, 
such as the asphyxia of the new-born, of the 
drowned, of convulsions, of cases of opium or 



prescreber's memoranda. 29 

carbonic oxide poisoning, etc. , is most favorable 
for the performance of the operation. The fol- 
lowing are the details of the procedure. In the 
adult or child with teeth, fix the jaws open by 
means of a cork, seize the tongue with a tena- 
culum or other instrument, draw it well out, 
and let it be held by an assistant. Pass the index 
finger of the left hand well down into the 
mouth, find the epiglottis, go beneath it, and 
place the finger over the laryngeal opening. 
Take a stiff catheter, No. 8 or No. 10, with the 
right hand, and using the left index finger in 
position as a guide, pass the instrument into the 
larynx. Be sure that the eyes of the instrument 
are well beyond the vocal cords. The assistant 
now extends the patient's arms above the head, 
the operator at the same time blowing up the 
lungs through the catheter. The arms are next 
brought down, and expiration accomplished by 
compressing the chest and abdomen. A respi- 
ratory act is thus accomplished. The proced- 
ure is continued with regularity, so as to 
simulate, as nearly as possible, the normal res- 
piratory interval. The insufflation through the 
catheter must be done gently." 

Dr. C. H. Humphreys has used nitrite of 
amyl successfully in the asphyxia of the new- 
born, when all other measures had failed, 



30 peesceibee's memoeanda. 

including Dr. Forest's method of artificial respi- 
ration. Place two or three drops on a handker- 
chief and lay it over the child's face, continuing 
at the same time some method of artificial 
respiration (in his case Sylvester's) ; allow it to 
remain about a minute, and then remove the 
cloth and observe the effect. 



ASTHMA. 

Apomorphia, subcutaneously in -fa gr. doses, 
has been found effective. 



I*. Lobelise fol. pulv., 
Stramonii fol. pulv., 

Belladonnae fol. pulv aa 3 ij. 

Potass, nitrat. pulv 3 iij. 

M. Keep tightly corked. 

The patient is required to shut himself in a 
small, warm, close room, and sprinkle the 
medicine on live coals, or smoke it in a fresh 
clay pipe, till relief is obtained, which is usual- 
ly within ten or fifteen minutes. 

Br. E. M. Lawrence, who has systematically 
studied the effect of ethyl iodide, recommends 
inhalations of 15 to 20 drops of this ether from 



prescriber's memoranda. 31 

a handkerchief, repeated three or four times 
daily, keeps the system constantly impregnated 
with iodine, and so proves a most useful agent 
in spasmodic asthma and other forms of nervous 
dyspnoea, as also in the dyspnoea of chronic 
bronchitis. We may mention, besides, the 
good results obtained by its inhalations in hay 
asthma. It seems to favor oxygenation of the 
blood and stimulates the respiratory muscles. 



ty . Tinct. lobeliaB § j. 

Ammon. iodidi . . . t 3 ij. 

Ammon. bromidi 3 iij. 

Syr. tolutan § iij. 

M. S. — A teaspoonful every one, two, three, 
or four hours. Bartholow. 

Of this prescription Dr. Bartholow says : "It 
gives relief in a few minutes, and sometimes the 
relief is permanent." 



The inhalation of carbolic-acid spray of a 
strength of five per cent, is now being used 
with advantage in coughs, bronchitis, etc. It 
is believed by some to be an absolute cure for 
all inflammations of the mucous membrane of 
the nose, throat, and lungs, and produces the 



32 PRESCRIBER'S MEMORANDA. 

desired effect by being brought into direct con- 
tact with the parts affected. 



I}. Iodide of potassium 3 ij. 

Decoction of senega 3 iij. 

Tiuct. of lobelia 3 vj. 

Camphorated tinct. of opium. 3 vj. 
M. S. — One to two teaspoonfuls three to four 
times per day. For asthma where there is em- 
physema or chronic bronchitis. 



I£. Spts. aether, co., 

Liq. morph. sulph. (U.S.). . .aa, fl. § j. 
M. Dose, from one teaspoonful to a table- 
spoonful. 



BALANITIS. 

.Dr. Vipecos publishes his treatment of this 
disease. First, he washes the glans with a weak 
solution of salt water; and after dressing the 
parts, he applies tannin dissolved in alcohol, 
equal parts. After the parts are dried, cold 
water is freely applied. By the fourth day, 
with this treatment, the inflammation has dis- 
appeared. 



prescriber's memoranda. 33 

BILIOUSNESS. 

The latest remedy for this affection is euony- 
min (Wahoo bark). 

I> . Euonymin 3ij. 

Ext. hyoscyami 3 j. 

Ext. gentianse gr. x. 

M. et div. in pil. no. xx. S. — One before 
dinner every second or third day. 

Especially serviceable in cases of hepatic dys- 
pepsia or u bilious attacks," with furred tongue, 
pale stools, lassitude, and general malaise. 

If the bowels are torpid, a little extract of 
nux vomica may be added. 



J^ . Mass hydrargyri, 

Ext. colocynth co aa gr. iij. 

M. et div. in pil. no. ij. S. — Take at once. 
To be followed by a saline purge. 

fy . Tinct. nucis vomicae gr. iv. 

"Resin podophyllin gr. iij. 

Ext. taraxaci gr. vj. 

Pil. catharsis co gr. xij. 

Fel. bovini gr. xxiv. 

M. Ft. pil. no. xij. S. — One at bedtime. 

Parker. 

3 



34 prescriber's memoranda. 

Excellent in u biliousness " with atony of the 
bowels. 



Miller's Pills. 

J},. Pulv. scammon., 
Pulv. aloes, 
Pulv. gambogise, 
Hydrarg. chlor. mit., 

Potass, bitarfc aa gr. xx. 

Ext. taraxaci q. s. 

M. Divide into 20 pills. 

This combination acts well in cases of chronic 
constipation with bilious symptoms. 



1£. Pil. hydrarg., 
Pulv. aloes Soc, 
Pulv. rhei, 

Ext. hyoscyami aa gr. vj. 

M. et div. in pil. no. vj. S. — Two every 
other night. 



BLADDER, Inflammation of. 

The following is frequently employed at Jef- 
ferson Medical College Hospital of Philadel- 
phia: 



prescriber's memoranda. 35 

3£ . Pulv. opii gr. xi j. 

Camphorae gr. xxx. 

Ext. belladonna? gr. iij. 

Cacao q. s. 

Mix et div. in suppos. no. vj. S. — One each 
night before retiring. 

In a very complete article on " chronic cysti- 
tis" M. Chauvel indicates the following prep- 
arations : 

^ . Turpentine § ss. 

Camphor gr. xv. 

Ext. hyoscyami gr. ss. 

M. S. — The ingredients are to be well mixed, 
and a piece the size of a cherry-stone taken 
morning and evening. 

Mr. Teevan and Dr. G-eo. Johnson recommend 
an exclusive milk diet in the treatment of cystitis 
and vesical irritation in children. For adults, 
one pint every two hours. 

Thompson frequently prescribes, with success, 
an infusion which can be given in all forms of 
chronic cystitis : 

5-. Uva3 ursi fol 3 3 . — ij . 

Pareiras bravaB rad 3 j.-ij. 

M. S. — Boil in a quart and a half of water 



36 PRESCRIBE!^ MEMORANDA. 

to a quart. Take from fl. § ij. to fl. 3 iv. , four 
or five times a day. 



M. Gosselin recommends benzoic acid, to pre- 
vent the development of ammonia. He gives at 
first fifteen grains per diem, gradually increasing 
to sixty and even ninety grains, without causing 
any trouble, save a slight parching of the throat. 
This treatment generally neutralizes the acidity 
of the urine after seven or eight days. 

Mr. Nunn uses quinine injections in cases of 
chronic cystitis with decomposition of the urine 
within the bladder. The following is the 
method of preparing and of using the solution : 
Dissolve twenty grains of disulphate of quinine 
in twenty-five ounces of water by the aid of a 
few drops of dilute sulphuric acid or a tea- 
spoonful of common brown vinegar. Of this so- 
lution inject into the bladder two or three 
ounces, and let it remain." 

The stigmata of maize is highly recommended 
by Mr. Dessein — infusion ( 3 ij. to Oj.). Wine- 
glassful every three or four hours. 



B . Borax I j. 

Glycerine 3 vj. 

M. Tablespoonful to a pint of water, and 
used as an injection in chronic cystitis. 



peesceibee's memoeanda. 37 

^ . Acid boracic 3 ij. 

Syr. lemon, 

Syr. zingib aa § j. 

Aquae ad. § vj. 

M. S. — A tablespoonful every two or three 
hours, in water. 



Langenbeck states that in atony of the blad- 
der associated with enlarged prostate, in el- 
derly men, in which the organ is never com- 
pletely emptied of urine, he has lately tried the 
hypodermic injection of ergotine with n>ost sur- 
prising results. In three cases the contractile 
power was at once increased, so as to enable the 
patient to discharge the additional urine, and in 
a few days it hu,d so augmented that very little 
urine was left behind. After one or two injec- 
tions the improvement was considerable, and 
even a diminution in the size of the prostate 
seemed to have ensued. 

Dr. Israel says that he has derived the same 
benefit from the employment of ergotine, and 
refers to the case of a patient who was thus 
enabled to hold his water for three hours, 
whereas before he voided it every ten min- 
utes. 



38 presckibeb's memoranda. 

BLISTERING FLUID. 

Granville's Blistering Lotion. 

V} . Aq. ammon. fort 3 iv. 

Spts. rosemary 3 iij. 

Spts. camphor 3 j. 

M. Produces vesication in from three to ten 
minutes. 



Granville' s Blistering Lotion^ stronger than c 

I) . Aq. ammon. fort 3 v. 

Spts. rosemary 3 ij, 

Spts. camphor 3 j. 

Cut a piece of linen the shape and size to be 
vesicated, saturate with above, apply, and cover 
for a few minutes with a dry cloth. 



BRONCHITIS. 

Dr. Bozzi has ascertained, as the result of a 
large experience, that the following medication 
cures acute bronchitis in the most certain and 
rapid manner : 

^ . Yellow sulphide of antimony, 

Dover's powder aa gr. xv. 

Powdered sugar Bijss. 

M. Divide into ten parts, and take one 



prescriber's memoranda. 39 

every three hours — but no more than four doses 
should be taken in the twenty -four hours. 
The same medication is also very useful in acute 
exacerbations of chronic bronchitis, as well as 
in that symptomatic of cardiac and pulmonary 
diseases. The diet should be limited to the use 
of warm sweetened milk and chicken soup. 
The temperature of the sick-room should not 
be lower than 60° Fahr. 



1} . Vini ipecacuanhae 3 ij. 

Liq. potassii citratis 3 iv. 

Tinct. opii camphoratse, 

Syr. acaciae aa 3 j. 

M. S. — A tatlespoonful thrice daily in the 
first stage of ordinary acute bronchitis. 

Da Costa. 

This union of the sedative effects of opium 
with the excito-secretory action of the ipecacu- 
anha on the congested mucous membrane has 
been found very serviceable. 



I£ . Fl. ext. yerba santa 3 vj. 

Fl. ext. senegae § iv. 

Syr. prun. virginian 3 ij. 

Aquaa ad. 3 iv. 

M. S. — A teaspoonful every three hours. 



40 prescriber's memoranda. 

Should the cough be aggravating, add a little 
opium. 

?. Vin. antimonial 3 ss. 

Vin. ipecac . 7T|_ xv. 

Tinct. camph. co 71^ xx. • 

Mucilag. acacias, 

Syr. scillse aa 3 iv. 

M. S. — 3 j. every two or three hours. In 
bronchitis, etc , for a child two years old. 

Ellis. 



3 . Antim. tartarat gr. j. 

Potass, nitrat 3 j. 

Mist, anrygdal § iij. 

M. S. — 33. every two* hours. In pneumo- 
nia, bronchitis, etc. Ellis. 



Blache has administered capsules containing 
thirty-five centigrammes of the crude petroleum 
with the following results : in chronic bronchitis, 
where expectoration is abundant, there is rapid 
diminution of secretion, and less frequency of 
the fits of coughing. In asthma similar results 
are obtained, with the disappearance of dysp- 
noea. In simple acute bronchitis, ifc has pro- 
duced a rapid amelioration. 



pkescriber's memoranda. 41 

I£ . Tinct. eucalyptus glob 3 iv. 

Syr. acacias § j. 

Aq. menthae pip ad. ? ilj. 

M. S. — 3 j. every three hours. In bron- 
chitis with profuse expectoration. 

For other prescriptions for bronchitis, see 
Cough Mixtures. 



BURNS. 

$ . White glue § vijss. 

Water, cold O j. 

Glycerine fl. § j. 

Carbolic acid fl. 3 ij. 

Soak the glue until it is soft ; then heat on 
water-bath until melted ; add the glycerine and 
carbolic acid, and continue heating until, in the 
intervals of stirring, a glossy, strong skin begins 
to form over the surface. When needed for 
use, heat on water-bath until melted, and apply 
with a flat brush over the burned part. 

]£ . Pulv. tragacanthse g ij. 

Pulv. acacias 3 iv. 

Syr. fusci (or molasses), 

Aquae bullientis aa Oj. 

M. Apply on sheet lint and cover with oil- 
silk. Buck. 



42 prescribes' S MEMORANDA. 

Lime Liniment. 

^ . Olei lini § vij. 

Aquae calcis fl. § viij . 

M. Apply on sheet lint and cover with oil- 
silk. 



A retired foundryman claims that powdered 
pine charcoal thickly dusted over a burn is a 
never-failing and speedy remedy. 



3 . Iodoform 3 j. 

Spermaceti J j. 

Ext. conium 3 ij. 

Carbolic acid. gtt. x. 

M. S. — Spread on some soft material and 
cover the parts. 

I) . Sodas carbonat § vj. 

Aquae Oiij. 

M. Apply freely by means of old cloths or 
sheet lint, and do not remove for three days. 
Result : Immediate relief to pain ; rapid healing-. 



CALCULI, Biliary. 

Dr. Buckler states that chloroform in from 
twenty to sixty drop doses every three or four 



prescriber's memoranda. 43 

hours, will in every instance dissolve hepatic 
calculi. As an addition to this treatment, and 
in cases where for some reason chloroform can- 
not be borne, he uses Stewart's hydrated succi- 
nate of the peroxide of iron, which contains a 
very large proportion of nascent oxygen. Dose, 
a teaspoonf ul after meals. 



CANCER. 

Cancer of the Cervix Uteri. — Whenever practi- 
cable, the whole cervix is removed by either 
the hot or cold wire. If this cannot be done, 
Dr. Goodell removes the malignant growth by 
scraping, or by means of the gouge-forceps, and 
the surface is subsequently charred with the 
thermo- cautery. This radical treatment is re- 
inforced by subsequent applications of the ethy- 
late of sodium. Tn these operations he finds 
that injections of ordinary vinegar form an ex- 
cellent means of controlling any embarrassing 
bleeding. 

Dr. Daniel Lewis says the treatment of can- 
cer by caustics is of almost equal value with 
that by excision, and is so recognized by many 
recent authorities. The agents which are in 
most common use are the strong sulphuric acid, 
nitric acid, caustic potash, terchloride of anti- 



44 peesceibee's memoranda. 

mony, bromine, chloride of zinc, and arsenious 
acid. The principal objection to most of these 
is the excessive pain attending their application. 
The least painful of the above-named is the 
arsenious acid, used according' to the method 
practised by Dr. Marsden, of the London Cancer 
Hospital, who, after an experience of nearly 
twenty years, and covering upward of six thou- 
sand cases of cancer, pronounces it superior to 
every other caustic. He recommends it in 
every form of cancer, except the cystic or col- 
loid varieties — provided the disease does not 
exceed four square inches in size — when re- 
moval by the knife appears to be the only 
remedy. Arsenic may be used in this way for 
cancers in every situation, except the interior 
of the mouth or nose, localities where the 
nature of the remedy makes it dangerous. 
The formula used at the Cancer Hospital is the 
following : 

]> . Arsenious acid 3 ij. 

Mucilage of gum acacia 3 j. 

Mix into a paste too thick to run. This is to 
be spread over the entire surface of the cancer, 
provided this does not exceed one square inch 
in size ; a bit of dry lint is then placed over the 
sore in order to absorb any excess of paste. In 



prescriber's memoranda. 45 

the course of an hour the lint becomes dry and 
hard, and adheres firmly to the parts. In the 
course of twenty-four hours some inflamma- 
tory action is visible in the tissues immedi- 
ately adjacent to the cancer. There is often 
also some pain, but this is not usually severe, 
and lasts but for a day or two. After the lapse 
of two or three days, according to circumstan- 
ces, bread and water poultices, changed every 
few hours, are to be constantly applied over the 
sore. A distinct line of demarcation is usually 
to be seen by this time, and the slough gradu- 
ally separates and comes away, leaving a heal- 
thy, cup-like depression, varying in depth and 
size according to the mass removed. Granula- 
tion proceeds rapidly, and the case is then 
treated as a simple ulcer. The slough sepa- 
rates at periods varying from six to thirty days, 
according to it3 size. The disease usually comes 
away entire with the slough ; but, where this is 
not the case, the paste is to be applied to the 
remaining portion, as in the first instance, every 
second or third day, till the desired effect is 
produced. The arsenic appears to have a posi- 
tive power of election, so that, if applied to 
sound tissue along with the cancerous, the 
diseased part alone is destroyed. Marsden's 
large experience seems to prove this conclu- 



46 pkesceibee's memoranda. 

sively. The arsenical paste is equally applicable 
to cancer, whether on the lip, face, head, arm, 
hand, abdomen, breast, penis, testicle, labium, 
scrotum, or foot; but must, as I have stated, 
be carefully watched, and never applied where 
the disease involves more than four square 
inches of tissue. Many medullary and scir- 
rhous cancers can be removed in this way, but 
it is especially applicable to the epithelial 
variety. Marsden believes that nine out of ten 
cases of this form may be perfectly cured if 
taken in time. 

Dr. Frank H. Hamilton says that the results 
of his investigation were unfavorable to cauter- 
ization as compared with excision. When the 
growth was removed by cauterization, the 
return was much earlier than when the knife 
was used. The question may be mooted, but 
it has not been decided in favor of caustics for 
the removal of either cancer or epithelioma. 
There are circumstances which warrant the 
use of caustics, but we must deny that it is the 
most radical method of curing either of these 
diseases. 

Dr. L. D. Bulkley says that arsenic seems to 
have an elective power, and does what no other 
caustic does — penetrate the diseased and not 
the healthy tissue. The pain attending the use 



peescbebee's memoranda. 47 

of the caustic paste i.3 inconsiderable. For that 
epithelial variety of cancer which begins upon 
the face between the ages of thirty-five and 
forty, and which, if treated superficially, will go 
on and form what is frequently called rodent 
ulcer, he believes it is a cure. 



Ghian turpentine has lately been recom- 
mended as a curative agent in cancer. Like 
the famous condurango, it is probably destined 
to prove utterly worthless. 



CARBUNCLE. 

M. Cezard recommends the following plan of 
treatment for carbuncular affections. First, 
support the organism; and second, neutralize 
the morbid effect of the poison. The one ob- 
ject may be accomplished by giving acetate of 
ammonia in doses varying from an ounce and a 
half to six ounces in twenty-four, and the other 
by the use of iodine, which may be given by the 
mouth or hypodermically. Local treatment 
should be instituted as soon as possible, and 
the swelling should be treated both by sub- 
cutaneous injection and by wet applications of 
iodine in a solution of one to one hundred. 



48 pkescribeb's memokanda. 

Poultices are thought to create a tendency to 
the formation of more carbuncles, if continued 
too long-. Quinine and iron should be given in 
large doses, also stimulants should be used freely. 



I£ . Calcii sulphide gr. x. 

Pulv. sacch. alb q. s. 

M. Twenty powders. S. — One every three 
hours. 



CATARRH, Nasal. 

For Dr. Massei, ozsena is a parasitic disease, 
and hence antiparasitic treatment is indicated. 
He divides his treatment into three stages, ac- 
cording to the following indications : dilatation 
of contracted nasal passages, cleansing and disin- 
fection of affected regions, and local medication. 

1. Dilatation. — When respiration is rendered 
difficult from contraction of the nasal passages 
by hypertrophy of the mucous membrane, and 
by the presence of a considerable quantity of 
thick and hardened secretion, Massei dilates 
them by the use of urethral bougies. 

2. Cleansing and Disinfection. — When the 
passages are sufficiently dilated, he orders fre- 
quent injections through them, by means of 
Fauvel's retro -pharyngeal syringe, of a very 



prescreber's memoranda. 49 

weak solution of salicylic acid ( 1 part to 500 of 
water). He considers this solution useful, not 
only as a disinfectant, but also as an astringent. 

3. Local Alterative Medication. — After the 
nasal fossas are well cleansed, he makes appli- 
cations, by means of the speculum nasi, of pow- 
dered calomel, upon the ulcerated portions of 
the mucous membrane. 

Massei warns practitioners that, when the ex- 
udation diminishes, there is always a halt in the 
course of the disease. It is just then that pa- 
tience must not be lost, but the insufflations 
rather insisted upon until complete cure is ob- 
tained. 



Although the present state of science does not 
permit the full acceptation of the parasitic 
theory of ozsena, still the excellent results ob- 
tained by this Neapolitan practitioner dispose 
us to follow the treatment which he proposes. 



$ . Loaf sugar 2 parts. 

Borax, 

Common salt aa 1 part. 

Oil of peppermint, a few 
drops. 
Triturate. S. — To be used as a snuff several 
times daily. 

4: 



50 prescriber's memoranda. 

Dr. Ferrier recommends for post-nasal catarrh 
a mixture of subnitrate of bismuth, 3 vj., pow- 
dered gum acacia, 3 ij- , and muriate of mor- 
phia, gr. ij., well mixed and used as a snuff in 
severe coryza or post-nasal catarrh. It acts in 
a most charming manner. 

Dr. A. G. Burness modifies Dr. Ferrier's snuff 
by using the lighter subcarbonate of bismuth, 
omitting the acacia, and using a little starch in- 
stead, if necessary. 

Dr. Pugin Thornton recommends the use of 
the following solution in the treatment of 
ozsena : 

B. Sodas carbonatis, 

Sodas biboratis aa, 3 ij. 

Liq. sodas chlorinatas 3 ss.- 3 ij- 

Glycerini § j. 

Aquae ad. § vj. 

M. Apply cold by means of a hand-spray ap- 
paratus. 



Dr. Q. C. Smith recommends for nasal catarrh 
liquor bismuthi and water, equal parts, applied 
one to three times a day, to nostrils, pharynx 
and naso-pharyngeal cavity, freely, with a spray- 
producer. Sulphocarbolate of zinc, in weak 
solution, as mentioned by other writers, he re- 



prescriber's memoranda. 51 

gards also as a very efficient remedy ; applied in 
the same manner. 

Dr. Lennox Browne recommends : 

J$, . Borax 3 iij. 

Salicylic acid 3 ij. 

Glycerine § ijss. 

Water, to make § iij. 

From one to two drachms in one -half pint of 
water, applied by means of a douche. Is espe- 
cially useful in catarrh with ulceration, usually 
due to syphilis. 

For simple catarrh he uses : 
1$. Chloride of ammonium, 

Borax aa gr. x. 



M. 

The above mixtures may be used advanta- 
geously with a spray-producer. 

It is generally accepted that the douche is 
not a safe method of treating nasal catarrh. 

I) . Iodoform gr. v.-viij. 

Ether fl. 3 j. -jss. 

Dissolve, and add : 

^ . Vaseline § j. 

Ottar roses tt[ v.-viij. 

S. To be applied with a brush. 



52 PRESCRIBER's MEMORANDA. 



CELLULITIS, Pelvic. 

Dr. William Goodell recommends the follow- 
ing : ' ' If you cannot abort the attack, take up 
the treatment regularly, and the first two and 
most important indications are : to stop the 
pain and to prevent the formation of pus. The 
medicines demanded are full doses of opium and 
bromide of potassium, together with from thirty 
to forty grains of quinia daily. In addition 
to this, paint the abdomen with iodine and put 
on a poultice. Some practitioners use as many 
as half a dozen poultices daily. The reason of 
this is that the poultices, being uncovered, dry 
up rapidly. If the poultice is covered with 
oiled silk, or greased brown paper,' one poultice 
will remain soft for twenty-four hours. Dur- 
ing this time the patient should be kept under 
the influence of large doses of quinia and 
morphia. Quinia contracts the capillaries, les- 
sens the flow of blood to the womb, and also 
inhibits the migration and transformation of 
white corpuscles into pus- corpuscles. If the 
woman be plethoric, the morphia may be given 
by the mouth with neutral mixtures and wine 
of ipecac, or in some other fever mixture. In 
some cases tonics are demanded. Occasionally 



pkesckibeb's memoranda. 53 

the application of belladonna and blue ointment 
locally is of benefit. 

" The disease ends either by resolution or in 
the secretion of pus. When pus is formed the 
tumor usually becomes a little softer, and this 
condition of things is accompanied by chills, 
night- sweats, and hectic fever, although these 
symptoms cannot be regarded as in any way 
pathognomonic. In nine out of ten cases the 
end is by resolution. When pus is formed the 
condition immediately becomes troublesome. 

" If the sickness, therefore, lasts for more than 
a week, and the local tenderness increases, ap- 
ply the hot- water douche to the tender cervix. 
Then you will very often find that after a few 
days the pain and inflammation subside, but 
there is still some fever in the afternoon. Now 
is the time to apply flying blisters. Begin with 
a good-sized one applied over the sore iliac 
region. In some cases this will be all that is 
required. When the pelvic tumor still remains, 
however, put another blister over the womb, 
and then another over the other side of the 
abdomen, and then begin over again, so going 
the rounds and keeping the skin raw in spots 
until you have gained the resolution of the exu- 
dation. In some rebellious cases of pelvic peri- 
tonitis a hard, tumor -like mass may exist for 



54 prescreber's memoranda. 

some time in the abdomen. I say pelvic peri- 
tonitis because cellular tissue would not harden 
in this way, but would degenerate into pus. 
When the cellulitis preponderates you are more 
likely to have pus formed, and instead of the 
chronic local hardness you have a chill and 
high pulse. 

" Very often the pulse will have fallen below 
100 and the temperature will have almost 
reached the normal, when a sudden chill will 
supervene, and the patient will complain of 
pain in the opposite iliac region. This is quite 
common as a sequel of abortion and in the puer- 
peral state, but is rare after operations. When 
this metastasis occurs the only thing to do is to 
begin again with large doses of quinia and 
of morphia, and give ten grains of quinia at a 
time, and, if necessary, from one-fourth to one- 
eighth of a grain of morphia hypodermically. 
This second attack will generally be found to 
be more manageable than the first. 

" When pus is formed, tonics are demanded, 
and among them iron. Never give iron, how- 
ever, in the early stages of the disease, as it is 
only too liable to send the blood to the womb, 
and so increase the already inflamed condition 
of that organ. Never keep the poultices on 
after the formation of pus has begun. Some 



presckibee's memoranda. 55 

authorities hold that poultices tend to the for- 
mation of pus. 

" It is in these later stages of the disease that 
muriate of ammonia is a very excellent remedy; 
so, too, is aconite. I usually prescribe the fol- 
lowing : 

U I£. Mist, glycyrrhizae comp fl. 3 vj. 

Ammonii chlor 3 ij. 

Hydrarg. chlor. corrosivi gr. j. 

Tinct. aconiti radicis gtt. xxiv. 

"M. S. — A tablespoonful in water every 
six hours. 

u Suppose that you are convinced that pus has 
formed and that you are unable to secure its 
absorption by medicinal means. Examine the 
vagina and see if you can detect any soft point 
which fluctuates, or pits upon pressure. The 
most common site for the pointing of pus 
formed, as a result of pelvic cellulitis and peri- 
tonitis, is the vagina ; the next most common 
site is the rectum. Of these two the vagina is 
the more desirable. Occasionally the pus emp- 
ties into the bladder. 

" When the spot has been found where the ab- 
scess is beginning to point, make an incision 
large enough to admit of a free drain of pus. 
Be as sure as you can be, however, before you 



56 peesceibee's memoeanda. 

cut an opening that all the small abscesses, if 
such there be, have melted down to form one 
large one. If the abscess is very slow in point- 
ing you will have a perfect right to search for 
the best point at which to introduce the aspira- 
ting-needle. In this way you may empty as 
many separate collections of pus as you can 
find." 



CHANCRE. 

Br. F. N. Otis gives the following rules for 
excision of the initial lesion of syphilis : First 
cleanse the parts thoroughly by gentle bathing in 
warm water ; in all open lesions apply a solution 
of carbolic acid of a strength of one part to forty 
of water, after which raise the mass of induration 
between the forefinger and thumb, and encircle 
it firmly at the base with a piece of fine silver or 
malleable iron wire. The indurated part may 
be separated from the normal tissue in the 
same way by compression between the arms of 
a bent probe, being careful to include the en- 
tire induration. Now, with a narrow, sharp- 
pointed bistoury, pierce the tissues at the cen- 
tre beneath the compressing wire or probe, and 



peesceibee's memoeanda. 57 

cut well under and out, including all the indura- 
ted and a little of the sound tissue of that side. 
This effected, from the place of beginning cut 
out in the same way on the opposite side. Be 
assured, by careful examination, that every por- 
tion of the neoplasm is removed ; then intro- 
duce uninterrupted sutures of silk or silver wire 
at intervals of one-fourth of an inch. The patient 
should be kept in the recumbent posture, the 
parts constantly wet with carbolated water, until 
the third day, when, on removal of the sutures, 
union by first intention will, as a rule, have 
taken place. The resulting cicatrix may indu- 
rate to a greater or less degree, but rarely, if 
ever, to the extent of inducing a solution of 
continuity. In no case does this procedure 
lessen the necessity for constitutional treat- 
ment. 

Dr. F. R. Sturgis says : " As regards treat- 
ment, it is simple, and, so far as local trouble is 
concerned, effective in the majority of cases. In 
the first place, let me beg of you never to cauter- 
ize an initial lesion unless it should be attacked 
by phagedena. I know it is the rule to cauter- 
ize every suspicious-looking ulcer ; but, in the 
case of the initial lesion, it not only does harm 
in irritating an otherwise simple ulceration, but 
it retards its healing. Dress the lesion simply ; 



58 prescriber's memoranda. 

sometimes a piece of lint laid over the ulceration 
or erosion will suffice, but at other times a little 
more active treatment may be requisite. Of 
all dressings I much prefer the dry, and of those 
iodoform heads the list, either alone or in com- 
bination with other drugs. Thus : 

I£ . Iodoform pulv. , 

Lycopodii pulv equal parts. 

Or, 

$ . Pulv. zinc, ox 2 parts. 

Pulv. iodoformi. 1 part. 

Or, 

1$. Pulv. hyd. chlor. mit 1 part. 

Pulv. iodoformi 2 parts. 

Calomel, without anything else, may also be 
used with advantage. 

A mode much practised in the German hospi- 
tals is to apply a piece of the emplastrum de 
vigo cum mercurio, the size of the ulcer, di- 
rectly upon the sore, and leave it thus protected 
from the air until the ulcer heals up. The 
Emplast. Hydrargyri, U.S. P., will answer as 
well. 

If you prefer to use a wet dressing, a weak 
solution of carbolic acid is the best, of which 
the following may serve as an example : 



pkesckiber's memoranda. 59 

I£. Cryst. acid, carbol gr. ij. 

Aquas § iv. 

M. Apply on lint or cotton thrice daily. 



CHILBLAINS. 

I£ . Acid, carbol 3 j. 

Tinct. iodinii 3 ij. 

Acid, tannici 3 ij. 

Cerat. simplicis § iv. 

M. S. — Ointment to be used at night. 

Bartholow. 



Poicder to prevent chilblains : 

^ . Sodium borate 3 parts. 

Alum, 

Benzoin aa 2 parts. 

Mustard 12 parts. 

Orris-root, 

Bran aa 10 parts. 

Almond-skins 30 parts. 

M. Mix with a little water and apply. 

Bandt. 



60 prescriber's memoranda. 

Wash for Non-ulcerated Chilblains : 
I£. Sulphate of aluminum and 

potash 1 part. 

Vinegar, 

Weak alcohol aa 25 parts. 

M. Dissolve and filter. Apply night and 
morning. Beasley. 

Ointment for the same : 

}£ . Prepared lard 8 parts. 

Crystallized acetate of lead ... 1 part. 
Distilled cherry-laurel water.. 2 parts. 
M. Apply night and morning. 

Giacomini. 

Ointment for the same : 

^ . Tincture of benzoin 1 part. 

Glycerine 2 parts. 

Linseed oil. 3f parts. 

Yellow cerate 2 parts. 

Spirits of lavender f part. 

Mix carefully. Apply night and morning. 

Orosi. 

I£ . Yellow wax 2 parts. 

Linseed oil 3f parts. 

Tincture of benzoin 2 parts. 

Glycerine q. s. 

M. Reveil. 



prescreber's memoranda. 61 

For Unbroken Chilblains. 

^ . Sulphuric acid 3 j- 

Spirits of turpentine 3 j. 

Olive oil 3 iij. 

Mix the oil and turpentine first, then gradu- 
ally add the acid. To be rubbed on two or 
three times a day. 



For Unbroken Chilblains. 

#. Lard I iv. 

Turpentine § j. 

Camphor 3 ij. 

Oil of rosemary 1TL xv. 

Rub in with continued friction. 



For Broken Chilblains. 

^ . Yellow wax, 

Olive oil, 

Camphorated oil aa § iij. 

Goulard extract § jss. 

Melt the wax with the oil, then add the 
camphorated oil and Goulard extract. 

]£ . Sulphurous acid 3 parts. 

Glycerine, 

Water. aa 1 part. 

M. 



62 prescriber's memoranda. 

CHAPS, etc. 

J$. Resinge |j. 

Cerse 3 iij. 

Adipis % ij. 

Zinci oxidi : 3 vij. 

M. 

I£ . Glycerine 3 ij. 

Spermaceti 3 j. 

White wax gr. xv. 

Essence of bitter almonds. . . . gtt. xvj. 

Melt the spermaceti and the wax together, 
add the glycerine and the essence, and stir till 
cold. Bouchut. 



CHOLERA INFANTUM. 

Dr. J. L. Teed says that in the congestive 
diarrhoea of children the following will be 
found to relieve the condition in a short time : 

^ . Hydrarg. chlor. mite gr. ~nj 

Pulv. ipecac gr. ~h—h 

Morphia acetat gr. / "-To o 

to each powder. To be repeated every two 



prescriber's memoranda. 63 

or three hours for a few doses ; to be followed 
by sodas potass, tart. 

In the hyperasmic form he gives a mild 
aperient first, then — 

1£. Hydrarg. c. creta, 
Pulv. rhei, 
Pulv. cinnamomi aa gr. j. 

repeated several times, afterward chalk mixture 
with bismuth. 

In the bilious form he first gives a mild laxa- 
tive in plenty of mucilaginous base. Then mer- 
cury and chalk with ipecac and sodas bicarb. , 
followed by ipecac and opium, and that by 
nitromuriatic acid and syrup. 

In chronic diarrhoea with watery stools, he 
uses hydrarg. c. creta gr. -g every hour. 

In the choleraic form (cholera infantum) he 
uses calomel in gr. J to gr. j. doses, in a little 
sugar, dry, on the tongue. 

Acetate of lead and morphia, in small doses, 
may prove of service. 

Stimulants are to be given. ^ o o gr- morphia 
may be used subcutaneously. Hot applications 
may allay vomiting. 

Dr. C. H. Avery has used the following, with 
excellent results, in the treatment of cholera 
infantum : 



64: pbesckiber's memobanda. 

3 • Acid, carbolic gr. xxiv. 

Spts. vini gtt. xxiv. 

Aquas menth. pip % jss. 

Mucil. acac 3 vi. 

Syr. papaveris rf . 3 vj. 

Tinct. opii gtt. x. 

M. et S. — Teaspoonful every two hours. 
Apply a spice-poultice to the stomach, made of 
cloves, cinnamon, and ginger mixed with brandy. 
The first effect is to check the vomiting, com- 
monly at once. The second effect is to change 
the character of the passages, which usually 
occurs within twenty-four hours. The third 
effect is to reduce the frequency of the pas- 



OHOREA. 

]£ . Chloral hydrate 3 ijss. 

Tinct. hyoscyami ^ j. 

Syr. limon ad. § j. 

Aquas cinnamomi § iv. 

M. et S. — Dose, 3 j. four times a day. 



Peyroud speaks highly of the use of arsenic 
subcutaneously in chorea. He uses : 



pbesckibek's memobanda. 65 

I£ . Liq. potassse arsenitis | ss. 

Aquas pur § j. 

M. From 5 to 10 drops of this solution, repre- 
senting from 2-J to 5 drops of Fowler's, is in- 
jected every third or fourth day. The chorea 
is cured, and the children gain in flesh during 
the treatment. It never causes inflammation 
or abscess. 

Simon says : " When the physician is called 
at the outset of the disease, dry cups should be 
applied along the spine each morning. In the 
way of calmants, he gives tinctures of aconite 
or hemlock, also tincture of colchicum as an 
antirheumatic. The acute stage being past, he 
orders tonics, phosphate of lime, saline baths, 
gymnastics. He does not advise the seaside for 
excitable subjects. If one desires the vivifying 
effect of the sea-air, it is best to keep the little 
patients at some distance from the shore. 

He also uses chloral in syr. camomile. 



Ether-spray to the nape of the neck, and the 
internal use of Fowler's solution, have given 
good results. 



Dr. Hayden has used strychnia and phospho- 
rus, in three-minim doses of the liquor, and 
5 



66 prescriber's memoranda. 

ethereal tincture, three times a day, with good 
results. 



COLIC, in Children. 

Dewed s Mixture : 

3£ . Magnesiae carb § ss. 

Tinct. asaf ostidaB gtt. xl. 

Tinct. opii gtt. xx. 

Sacch. alb 3 j. 

Aquas destillat § j. 

M. Twenty drops for child two to four weeks 

old. 

$ . Tinct. asaf oetidse gtt. xv. 

Tinct. cinnamomi § ss. 

Syr. rhei aromat 3 iij. 

Aquas § jss. 

M. Dose, 3 j. Brunner. 

5 . Potass, carb gr. ij. 

Olei cajeput TT^ j. 

Aquas anethi 3 ij* 

M. S. — Three or four times a day. 

Fothergill. 



prescriber's memoranda. 67 

This alkaline mixture will afford speedy relief 
to infants who have griping pains after taking 
milk — a condition very frequent and exceedingly 
annoying. 



Colica Pictonum. — Croton-oil, in half -drop 
doses, combined with sufficient opium to relieve 
the pain, and repeated every three or four hours 
until free evacuation of the bowels is pro- 
duced. 



CONJUNCTIVITIS. 

I£ . Sodas biborat gr. x. 

Aquae |ij. 

M. To spray the eyes in conjunctivitis during 
nflammation. Later the next may be used. 



]£. Alum vel. potass, chlorat 2 parts. 

Aquae 100 parts. 

M. To cleanse the eyes. 

3£ . Sodium chlor 3 j . 

Aquae gj. 

M. 



68 prescreber's memoranda. 

]£. Hydrarg. oxid. flav gr. ij. 

Vaseline § j. 

M. Seely. 



3 • Zinci sulphatis, 
Cupri sulph., 
Ferri sulph., 

Alum sulph aa 3 j. 

M. Saturated solution for severe cases, weaker 
solution for milder cases. Holmes. 

1$. Liq. plumbi subacetat § j. 

AquaB 3 iij. 

M. To be applied by the surgeon to the 
everted lids, and then washed off with water. 

BtTLLER. 



CONSUMPTION. 

1$, . Olei morrhuae fl. § j. 

Tinct. iodinii comp TT^ xvj. 

M. Dose, one to four teaspoonfuls. 



3$. Mist, olei morrhuse fl. J j. 

^Etheris TIL xvj. 

M. Dose, one to four teaspoonfuls. 



presceiber's memoranda. 69 

IjL Olei morrhuas, 

Mucil. acacias aa fl. 3 ij. 

Fiat emulsio et adde — 

Syrupi calcis lactophosphatis . fl. § ss. 



^ . Morph. sulph gr. ij. 

Acid, sulph. dil . . gtt. ij. 

M. et adde — 

Tinct. serpentarias § j. 

Vini antimonii, 

Vini ipecacuanhas aa 3 ij. 

Tinct. anisi 3 j. 

Syr. pruni Virgin § iv. 

M. ft. sol. Dose, a teaspoonful every two or 
three hours. 



$ . Syr. calcis lactophosphat J ij. 

Spts. frumenti § V J SS - 

Glycerinas purse \ vj. 

Tinct. cinchonas 3 jss. 



]£ . Vini f erri § iv. 

Quin. sulphat § j. 

Glycerinas puraa § viij. 

Spts. frumenti § iv. 



70 prescriber's memoranda. 

I£. Glycerin as purse, 

Spts. frumertti aa ^vj. 

Ext. pruni Virgin fl. § iv. 

Useful with a cough, when the tonic and seda- 
tive influence of the cherry bark is indicated. 

Of either of these three mixtures one or two 
tablespoonfuls may be given three or four times 
a day. 



Dr. H. Gibbons, jr., uses the following to re- 
lieve the night cough and restlessness of pa- 
tients suffering with phthisis : 

$. Tinct. belladonnas 3 ij- 

Syr. scillas § ij. 

Morphias sulphatis gr. iv. 

Syr. tolutani ad. § iv. 

M. S. — A tablespoonful at bedtime, re- 
peated, if necessary. 



" Rye and Rocky 

3 . Spiritus f rumenti Oj . 

Glycerine § ij. 

Rock candy § xvj. 



Fothergill says, with reference to the treat- 
ment of early phthisis: "It is as important 
to study the tongue as the chest ; attention 



prescriber's memoranda. 71 

to the stomach and bowels is as essential 
as the treatment of night- sweats. It is use- 
less to give cod-liver oil when the tongue is 
covered with thick fur ; administer rather a 
co. calomel and colocynth pill every night, and 
a nitrohydrochloric acid mixture with an infu- 
sion of cinchona, ter die, until the tongue clears. 
If the tongue is raw, give bismuth with an al- 
kali, and milk diet. Seltzer water and milk 
may be used when milk alone is too heavy and 
constipating. When the tongue becomes nor- 
mal, then the cod-liver oil and iron may be ad- 
ministered. Diarrhoea is checked by a pill of 
f erri sulph. , gr. ss. , and opium gr. j. ; rice-water 
being used as a drink. Hydrobromic acid with 
spts. chloroform affords relief from harassing 
cough. " 



1£ . Yolk of eggs no. ij. 

Mint-water 3 iijss. 

Triturate, and add by trituration — 

Loaf sugar, grained § ij. 

Triturate, and add by trituration — 

Cod-liver oil 3 viij. 

Spts. frumenti 5 vijss. 

Tinct. opii camph % iij. 

M. Make emulsion. 



72 pbesceibek's mdbmoranda. 

Tasteless Cod-liver Oil Mixture. 

ty . Olei morrhuae 3 vij. 

Spts. lavand. comp., 
M. Brandy aa 3 j. 

$ . Olei morrhuse § ss. 

Mucilag. acaciae § ij. 

Sacchari 3 ij. 

Tinct. lavand. comp Tf^ xx. 

Aquae § ss. 

M. Dose : A teaspoonful. 
Agreeable form of taking cod-liver oil, for 
children. Farquharson. 



^ . Olei morrhuae, 

Aquae calcis aa fl. § viij. 

Olei cinnamomi gtt. x. 

M. Dose, a tablespoonful. 

$. Olei morrhuae 18 parts. 

G-lyconini (see third below). 9 parts. 

Spts. ammon. arom 1 part. 

Vini Xerici 20 parts. 

Spts. amygdal. amar 2 parts. 

M. All to be taken by weight. The spiritus 
amygdalae amarae is made by mixing one part of 
oil of bitter almonds with sixty-four parts of al- 
cohol. Dose, a tablespoonful. 



prescriber's memoranda. 73 

3. Olei morrhuse 20 parts. 

Olei phosphorati (1 per cent. ) 2 parts. 

Glyconini 7 parts. 

Spts. amnion, arom 1 part. 

Syr 10 parts. 

Acidi phosphor, dil 4 parts. 

Spts. amygdal. arnar 2 parts. 

M. All by weight. Put the glyconin into a 
mortar and add the oils to it in very small quan- 
tity at a time, triturating the mixture actively 
and constantly. Then add the other ingredi- 
ents in the order in which they are named. 
Dose : a tablespoonf ul. 



^ . Olei morrhuaB fl. § ij. 

Aquae calcis fl. § ss. 

Syr. calcis lactophosph fl. § jss. 

M. Dose, a tablespoonful. Bosley. 



Glyconini. 

^ . Vitellorum ovorum 4 parts. 

Glycerinse 5 parts. 

Beat or whip the yolks of the eggs, which 
must be fresh, in the usual manner ; pour the 
liquid into a bottle, add the glycerine, and shake 



74: prescriber's memorajstda. 

them well together. One pint of cod-liver oil 
requires about four fluid ounces of glyconin to 
emulsionize it. 



Dr. Reuss does not desire to make creasote 
an universal panacea in phthisis, but he be- 
lieves that, administered in an inoffensive form, 
it may render great services. The formula 
which he employs is the following : 

^ . Pure balsam of tolu 4 parts. 

Pure beach creosote 1 part. 

Excipient q. s. 

M. 

He gives this preparation in the form of 
dragees, or capsules, and orders two in the 
morning and two at night, gradually increasing 
the dose up to ten per day. 



The committee of the New York Therapeuti- 
cal Society, from an investigation of the evi- 
dence before them, felt warranted in drawing 
the following conclusions : 

1. That the addition of ether to cod-liver oil, 
in about the proportion of fifteen minims to 
each half- ounce (or an equivalent amount of 
the compound spirit of ether), will succeed in 



pkescribeb's memoranda. 75 

the vast majority of cases in enabling" the pa- 
tient to take the oil, even though it previously 
disagreed. 

2. That, in some cases in which the oil still 
disagrees after the addition of the ether, the 
difficulty may be overcome by giving the ether 
separately from fifteen minutes to half au hour 
after the oil is taken. 

JNo facts have been laid before the commit- 
tee having a bearing upon the question as to 
whether the etherized oil is superior to the 
plain oil in its ultimate effect upon nutrition, 
supposing them to be equally well tolerated by 
the stomach. 



COUGH MIXTURES. 

Stokers Cough Mixture. 

I£ . Ammon. carb gr. xxxij. 

Ext. senega fld., 

Ext. scillas fld aa 3 j. 

Tinct. opii camphorat 3 vj. 

Aquae § jss. 

Syr. tolut q. s. ad. § iv. 

M. S.—A teaspoonful. 



76 pkescribeb's memoranda. 

WedeVs Pectoral Powder. 
3£ . Acid, benzoici gr. viij, 

Sulphuris loti gr. lxxv. 

Glycyrrhizse rad 3 ijss. 

Iridis florentin. rad 3 ss. 

Sacchari 3 v. 

Olei anisi, 

Olei f oeniculi aa gtt. iv. 

M. Fiat. pulv. Dose, a tablespoonful three 
or four times a day, in bronchitis, severe cough, 
or croup. 



32 . Pulv. ext. glycyrrh. , 

Pulv. sacchari, 

Pulv. acacias . . .aa 3 j. 

Tinct. opii camph fl. 3 ss. 

Vini antimonii fl. 3 ij. 

Spts. aetheris nit fl. 3 j. 

Aquas q. s. ad. fl. § iv. 

M. Dose, a teaspoonf ul. Shake before using. 
This mixture makes a good vehicle for the ad- 
ministration of muriate of ammonia. 



^ . Potass, bromidi 3 iv. 

Potass, cyanidi gr. iv. 

Syr. pruni Virgin fl. § iv. 

M. Dose, a teaspoonful. 



prescriber's memoranda. 77 

1$, . Amuionii carbon gr. 1. 

Potass, iodidi 3 iij. 

Syr. pruni Virg. , 

Spts. aether, co aa fl. § jss. 

M. Dose, a teaspoonf ul. Stimulant and ex- 
pectorant. Katzenbach. 



I£ . Tinct. tolutanae fl. 3 ij. 

Syr. senegas fl. 3 ss. 

Acid, acet fl. § jss 

Syr. pruni Virg q. s. ad. fl. J ij. 

M. Dose, a teaspoonf ul. 



I£. Acid, hydrocyan. dil., 

Chloroformi purif aa, fl. 3 j. 

Tinct. hyoscyami, 

Syr. tolutani, 

Aquas camphoras, 

Mucil. acacias aa fl. § j. 

M. Dose, a teaspoonful. Katzenbach. 



The inhalation of carbolic acid spray, of a 
strength of five per cent. , is now being used with 
advantage in coughs, asthma, and chronic ca- 
tarrh. 



78 presckebee's memoranda. 

I£. Acid, hydrocyan. dil gtt. viij. 

Syr. simp 3 ijss. 

Aquae destill 3 xv. 

M. S. — Teaspoonful every four hours In 
case of failure, the dose to be increased till one 
and a half teaspoonful is taken every three hours. 
Night cough of children. Macdonald. 

$ . Tinct. nucis vom fl. 3 ij. 

Vin. ipecac fl. 3 ijss. 

Syr. sarsap. co. s 

Syr. senegae aa fl. § jss. 

M. Dose, a teaspoonful, for children. 

]£ . Potass, nitrat gr. j. 

Spts. aether, nit., 

Syr. ipecac aa fl. 3 ss. 

Syr. pruni Virg fl- 3 ij. 

Aquae q. s. ad. fl. | j. 

M. Dose, a teaspoonful, for children. 

Robinson. 

5 . Vini antimonii fl- 3 j. 

Syr. ipecac fl. 3 ij. 

Tinct. opii camph fl. 3 j. 

Spts. aetheris nit fl- 3 ij. 

Ext. glycyrrhizae gr. xv. 

Aquae fl. 3 ij- 

M. Dose, one or two teaspoonfuls. 



frescrebeb's memoranda. 79 

$. Potass, cyanidi > gr. ij. 

Viiii antimonii fl. 3 i j. 

Syr. tolut., 

Mucil. acaciae aa fl. § ss. 

Aquae q. s. ad. fl. § ij. 

M. Dose, a teaspoonful. 

I£ . Acid, hydrocyan. dil tf^ x. 

Syr. papav. alb 3 iij. 

Aquae flor. aurant ad. § vj. 

M. S. — 3 j. , capiend. secund. vel tert. horis. 
In spasmodic cough for a child three years old, 
the dose may be cautiously increased. Ellis. 

1£ . Acid hydrobrom. dil. (34$) ... fl. 3 ss. 

Spts. chlorof ormi 71^ xv. 

Syr. scillae fl. 3 j. 

Aquae q. s. ad. fl. § j. 

M. One dose, to be taken twice or thrice 
daily, for nervous cough. 

J£ . Ammonii carbonat 3 ss. 

Syr. senegae fl. 3 iv. 

Syr. ipecac fl. 3 ij. 

Syr. tolut fl. 3 iv. 

Ext. gly cyrrh 3 ss. 

Aquae cinnam q. s. ad. fl. § iv. 

M. Dose, a teaspoonful, for children. 

Bosley. 



80 pkescbiber's memoranda. 

5 . Morphias sulph gr. xvj. 

Syr. scillas, 

Syr. ipecac aa fl. § xvj. 

Syr. tolut., 

Syr. pruni Virg aa.fl. § xij. 

Tinct. benz. co., 

Tinct. sanguinarias aa fl. J iv. 

Aquas fl. § vj. 

M. Dose, a teaspoonful. 



]£ . Ammonii chloridi gr. iijss. 

Potassii chlorat gr. xl. 

Syr. senegas fl. 3 iv. 

Syr. ipecac e fl. 3 iij . 

Syr. tolut fl. 3 v. 

Ext. glycyrrhizas 3 j. 

Aquas cinnam q. s. ad. fl. § iv. 

M. Dose, a teaspoonful, for children. 

BOSLEY. 



3 . Acid, hydrobrom gtt. xx. 

Ext. scillas gr. ss. 

Spts. chloroform fl. 3 ss. 

M. S. — Every three hours. 

FOTHERGILL. 



pbescribeb's memoranda. 81 

B . Ammoiiii chlor gr. xx. 

Aceti scillse fl. 3 j- 

Mist, glycyrrhizse comp fl. 3 vij. 

M. Dose, two to four teaspoonfuls. 

5 . Ammonii carbon gr. x. 

Syr. ipecac fl. 3 jsa. 

Tinct. opii camph fl- 3 j. 

Syr. pruni Virg fl. 3 ss. 

Aquae q. s. ad. fl. 1 ij. 

M, Dose, a teaspoonful for children with 
bronchitis. Robinson. 



3. Tinct. opii camph., 

Spts. ammon. arom aa fl. § j. 

Ext. ipecac fl. 3 ss. 

Syr. pruni Virgin . fl. § j. 

Aqua3 q. s. ad. fl. § iij. 

M. Dose, a teaspoonful for infants. 



$ . Potass, chlorat 3 j. 

Ext. glycyrrhizaa 3 ss. 

Ammonii chlor 3 j. 

Aquas fl. § iv. 

M. Dose, a teaspoonful. Wheelock. 

6 



82 pbescbibeb's memobanda. 

5 . Potass, iodid 3 iij. 

Tinct. tolut fl. 3 j. 

Ext. pruni Virg. fl. . , fl. 3 j. 

Syrupi fl. g j. 

Spts. setheris co fl. § ij. 

Aquae fl. I j. 

M. Dose, a teaspoonful. J anew ay. 



]£. Acid, hydrocyanic, dil., 

Chloroform aa 3 j. 

Tinct. hyoscyam § ss. 

Aquae camph ad. § ij. 

M. S. — Teaspoonful in a wineglass of water, 
three or four times a day, to relieve the cough 
of consumption. A. A. Smith. 



CONSTIPATION. 

]£. Ext. rhamni pursh. (cascara) . § j. 

Ext. belladonnae 3 j. 

Tinct. nucis vomicae 3 ij. 

Syrupi et aquae aa ad. § iv. 

M. S. — Spoonful three times a day. In ob- 
stinate chronic constipation. Clabke. 



pbesckeber's memoranda. 83 

$. Ext. colocynth. comp gr. ij. 

Ext. belladonnas gr. £. 

Ext. gentianae gr. j. 

Olei carui gtt. ss. 

M. et ft. pil. no. 3. To be taken at bedtime. 



The pulvis glycyrrhizas comp. of the Prussian 
Pharmacopoeia is another good laxative. Pa- 
tients can take it for months, and always with 
benefit. The formula for it is as follows : 

^. Pulv. glycyrrh. rad., 

Pulv. sennas aa 1 ss. 

Sulphuris sublim., 

Pulv. f osniculi aa 3 ij. 

Sacchar. purif § jss. 

M. S. — One teaspoonf ul in half a cupful of 
water, at bedtime. Goodell. 



]£ . Ext. belladon gr. v. 

Ext. nucis vom gr. x. 

Ext. colocy. co 3 j. 

M. et div. pil. no. xx. 

S. — One at bedtime. If the colocynth gripes, 
add 3ij. of bicarb, sodas and divide into 40 pills, 
and take two at bedtime. Thomson. 



84 peesceibeb's memoeanda. 

IJ. Aloes Soc gr. ss. 

Rhei gr. ij. 

Ext. bell gr. -fo 

M. Ft. pil. p. r. n. Da Costa. 

1$. Res. podophylli gr. xxiv. 

Gambogias 3 j. 

Pulv. aloes § ss. 

Hydrarg. chlor. mit 3 ij. 

Pulv. zingiber., 

Pulv. capsici aa 3 ij. 

Ext. taraxaci q. s. 

M. Divide into 240 pills. Janeway. 



I}. Pulv. rhei, 

Pulv. aloes aa gr. xv. 

Ext. bellad., 

Ext. nucis vom. , 

Resin, podophylli aa gr. iij. 

Olei caryophylli gtt. v. 

M. Divide into 12 pills. Dose, one pill 
mornings and evenings. 



Buckthorn (Rhamnus frangula) is a favorite 
and useful remedy with the profession, as a 
cathartic and laxative, especially in combination 
with other remedies. From repeated trials a 



pkescribee's memoranda. 85 

better effect from rhamnus purshiana, or cas- 
cara sagrada, is obtained in the form of the 
fluid extract. An excellent combination, in 
constipation dependent upon an atonic condition 
of the alimentary canal, is the following : 

If. Ext. cascara sagrada fl 3 j. 

Ext. malt, 

Syr. simp aa ad. § v. 

M. S. — 3 j. ter in die. 

Dr. G. S. Wells believes that cascara sagrada, 
in moderate doses, is the best single remedy 
for costiveness yet introduced into practice. 
He combines it with nitro-muriatic acid, and 
sometimes adds one-fortieth grain doses of 
strychnia. Has tried cascara cordial in up- 
wards of thirty cases. It is too weak for drachm 
doses, and he thinks that more of the base can 
be used without injuring its claims for elegance. 



CONVULSIONS IN CHILDREN. 

Ijfc . Chloral hydrate gr. x. 

Fresh milk 1 j. 

M. Rectal injection. 



86 pkescriber's memoranda. 

In very young children the dose should be re- 
duced by injecting one- third, one -fourth, one- 
sixth, of this quantity of chloral. Hot baths, 
mustard, lancing the gums when necessary, etc., 
are all to be attended to. Chloral gives better 
results than any other drug. 

Ferrand advises the hot bath, bromide of 
potassium internally, inhalations of chloroform; 
in case of extreme violence of the convulsions, 
anointing the axillas with belladonna ointment. 
If the indications require action of the bowels, 
he prescribes calomel in place of the bromide, 
or alternating with it. Id grave forms it is 
well to apply leeches back of the ears. 

Dr. A. A. Smith says, whatever the cause, 
the convulsion should be arrested and another 
prevented by the administration of anaesthetics, 
preferably chloroform. If the convulsions are 
due to pain produced by causes other than those 
which can be readily removed — as an overloaded 
stomach, which can be easily emptied — opium is 
the most valuable remedy, and he employs it if 
the child is more than four months old. 

Convulsions dependent on the pain of teeth- 
ing should be controlled : first, by opium, and 
second, the gum-lance. 

Convulsions dependent on the pain produced 
by worms, or other foreign bodies in the intes- 



prescriber's memoranda. 87 

tinal canal, or errors in feeding, should be first 
controlled by opium, and then a cathartic should 
be given. The cathartic and opiate may be 
combined with advantage. If the gums are hot 
and swollen, they should be lanced. If it is 
time for the tooth to appear, the gum should be 
scarified. The hot bath in the treatment of 
convulsions should be rejected. 

If the child is under four months old, give a 
teaspoonful of the following mixture every 
hour : 

If. Sodae bromid. , 
Chloral hydrate, 

Sodas bicarb aa gr. viij. 

Aquae § j. 

M. 

Double the quantity may be given to a child 
from six weeks to four months of age, every 
hour or two hours, according to the frequency 
and the severity of the convulsions. 

Dr. J. Lewis Smith relies upon the bromides, 
of potassium preferably, in large doses fre- 
quently repeated — two to six grains for a child 
over two months and under one year of age, re- 
peated every ten, fifteen, or twenty minutes, ac- 
cording to the severity of the case — to control 



88 pkescriber's memoranda. 

the irritation produced by the irruption of the 
teeth. He gives hydrate of chloral in convul- 
sions of children, and always by rectal injec- 
tion. He believes the hot bath to be a bene- 
ficial agent, and certainly when a child is 
threatened with convulsions, has twitchings, 
etc. He does not give anaesthetics in this class 
of cases. 

Dr. S. T. Hubbard fears to use opium in 
children. He has used the bromides and chloral 
with good success in the treatment of convul- 
sions of children. He uses chloroform, and be- 
lieves that anaesthetics are beneficial in arresting 
the convulsions. He uses a modified hot bath : 
strip the child, then wrap it in flannel wrung 
out of hot water, and cover with a dry flannel 
blanket. 

Dr. Engel reports a case in which the nitrite 
of amyl was successfully used. The parents had 
lost three children previously by epileptiform 
convulsions of the same character as those af- 
fecting the present case. The child, eighteen 
months old, had continued in convulsions for 
five hours, and was apparently moribund, when, 
as a last resort, five drops of the amyl were 
given along with one-fourth grain of morphia. 
The child at once went off into a quiet sleep. 



prescribeb's memoranda. 89 

CONVULSIONS, Puerperal. 

Br. H. H. Kane believes that chloral gives the 
best results in this disease. He recommends a 
rectal injection of 3 j. of chloral in milk, fol- 
lowed by others of 15 gr. each every hour until 
the convulsions cease. 



Dr. T. Gaillard Thomas says : ' ' Stop the con- 
vulsions and do not permit them to return, and 
for that purpose use chloroform. Get the kid- 
neys to work as soon as possible ; deliver the 
woman as soon as can be done with safety to the 
mother and the child." 



The late Dr. Edmund R. Peaslee said : " Place 
the woman at once under the use of chloroform, 
for the purpose of preventing the further occur- 
rence of convulsions. She may be held under 
its influence for almost any length of time, if it 
is properly administered, and not to the extent 
of producing stertorous breathing. This is done 
with the view of saving the brain, relieving the 
pressure upon the great nervous centres. Next, 
in every possible way hurry the labor. Get rid 
of the child as soon as possible ; save it if you 
can; at the same time do not risk the life of 



90 prescriber's memoranda. 

the mother. Secure free action of the skin, the 
kidneys, and the bowels, without delay. " 



CROUP. 

A teaspoonful of glycerine often proves 
emetic to young children with croup. 



Dr. Fordyce Barker speaks highly of from 3 
to 5 grains of turpeth mineral, repeated if vom- 
iting does not take place. 



The ^o to -fg- gr. apomorphia has been used 
for the same purpose. Also to cure without 
producing vomiting. 



Dr. Smidowisch mentions four cases in which 
apomorphine was used by him. with success in 
croup and acute laryngitis. In these cases 
large doses were borne ; for instance, to one boy, 
one and one-half year old, who was suffering 
from severe croup, from 0.06 (seven-eighths of a 
grain) to 0. 07 (one and one-tenth of a grain) of a 
gramme per day for five days was given. But 
toward the close of the disease a dose of 0.004 
(grain one-sixteenth) of a gramme could not be 
borne. This case is the more interesting be- 



prescriber's memoranda. 91 

cause, after two and one-half years, a second 
attack of croup in the same child was likewise 
removed by the use of apomorphine. In the 
second instance the dose given was from one to 
one and a half teaspoonful of a one per cent, 
solution of apomorphine hourly. 

Dr. Netolitzky has employed the treatment of 
croup recommended by Dr. Schutz three years 
ago, in nine cases with seven recoveries. He 
used the following formula : Vy . Bromi puri, 
potass, bromidi, aa grs. vijss.-xv. • aquae, 3 v.-vij. 
M. This solution was poured on a small sponge 
or on cotton, and the patients inhaled the va- 
por given off by it for five or ten minutes every 
half -hour. The potash is added to retard the 
too rapid volatilization of the bromine, which ne- 
cessitates also a frequent moistening of the 
sponge or cotton. When there was a tendency 
to renewal of the exudation, the inhalations 
were continued for a prolonged period, but 
weaker solutions were used. Ipecac and other 
expectorants were given at the same time. One 
great advantage of these inhalations is the fa- 
cility with which they can be administered, no 
special apparatus being required. They do not 
excite any affection of the respiratory organs. 
and are not specially liable to excite cough. 



92 prescriber's memoranda. 

I£ . Vin. antimon 3 rj. 

Syr. papaveris 3 iv. 

Syr. tolu 3 ij. 

Aquas I j. 

M. Administer in as large doses as possible 
without producing vomiting, and repeat every 
hour. Delafield. 



~Rf. Tinct. eucalyptus 3 iv. 

Syr. limon § ss. 

Aquae pur ad. f iij. 

M. Teaspoonful every hour. 
Spoken of highly in croup and diphtheria by 
Dr. Walcher. 



Acid, hydrocyanici dil. Dose, 1fT[_ -£~j. always 
to be cautiously given. 

¥?, . Acidi hydrocyan. dil TIL ij. 

Tinct. hyoscyam TTL xx. 

Syr. aurant 3 ss. 

Mist, amygdal § ij. 

M. Dose, 3 ij . may be given frequently in per- 
tussis, laryngismus stridulus, croupy cough, 
etc., to a child five years old. 3 j. for a child 
two years old. Ellis. 



pbescbiber's memoranda. 93 

COUNTER-IRRITANTS AND CAUSTICS. 

3. Chloral hydrate, 

Gum camphor aa 3 ij- 

Rub together in a mortar until an oily liquid 
results. An excellent application in neuralgia. 

1$ . Iodin. pur | ijss. 

Potass, iodid § ss. 

Spts. rectificat fl. § xij. 

Alcohol ^iv t 

The above is the correct formula, for Church- 
ill's tincture of iodine, as given in the fifth 
edition of his work on Diseases of Women. 



An elastic pencil of lunar caustic may be 
prepared by dipping a laminaria-tent, two mil- 
limetres in diameter, into tolerably thick mu- 
cilage, and then rolling it in finely powdered 
nitrate of silver. After drying, an elastic pencil, 
the size of the ordinary slate, remains, which 
may be readily introduced into the uterine or 
other cavity without fear of fracture. The 
above method of cauterizing the cervix and in- 
terior of the uterus will be found of ready ser- 
vice and of extreme value by those engaged in 
gynecological practice. 



94 prescriber's memoranda. 

Mb Creadtfs Plaster. 

Spread adhesive plaster with oleoresina cap- 
sici, leaving, however, a narrow margin all 
around free. 



DobelVs Solution. 

$ . Acid, carbol 3 jss. 

Sodas bibor., 

Sodae bicarb aa 3 ij. 

Glycerinae fl. g iij. 

Aquae q. s. ad. Oij. 

M. For external use. 



The so-called painless caustic powder of Es- 
march is prepared as follows : Arsenious acid, 
1 part ; morphia sulphate, 1 part ; calomel, 8 
parts ; pulv. gum arabic, 48 parts. M. 



Strong Croton- Oil Paint {Corson 1 s). 

$ . Olei tiglii. , fl. 3 ij. 

iEtheris sulph * , fl. 3 iv. 

Tinct. iodine fl- 3 ij- 

Potass, iodid gr. xx. 

Iodine crystals gr. x. 

M. Shake well before applying. Two to four 
coats at a time, and on an average once a week, 
over a space from one to five inches square ; 
less in females than in males. 



prescriber's memoranda. 95 

Mild Croton- Oil Paint (Corson's). 

9 . Olei tiglii fl. 3 ss. 

JEtheris sulph fl. 5 j- 

Tinct. iodinii fl. 3 ijss. 

M. For children and delicate females. 



Vienna Paste. 

5 . Potassse, 

Calc. caustic aa equal parts. 

M. When used, mix with equal part of strong 
alcohol. 



Comers Powder. 

5 . Acid, arsenios 3 ij. 

Hydrarg. sulph. rub § j. 

Carbon animalis 3 ij. 

M. 



CYSTITIS (see Bladder). 



DIABETES MELLITUS. 

Dr. George W. Balfour recommends the milk 
treatment, especially if conjoined with other 
treatment which is considered appropriate to 
such cases. 



96 pbesceibeb's memoranda. 

A. Bouchardat, Professor of Hygiene to the 
Faculty of Medicine at Paris, states that, by 
a comparison of the articles of food which a 
diabetic patient may take without prejudice, it 
is quite possible to keep up a sufficient degree 
of variety to make a very satisfactory living. 
All sorts of meats, roast and stewed, and even 
dressed with spices, but not with flour ; fresh- 
water and marine fish, the eating of which sup- 
plies the want of bread to some extent — at least 
more than meat; oysters, mussels, crabs, lob- 
sters, etc. Eggs in all forms, with good, rich 
cream, but no milk, vegetables, cabbage, salads, 
lettuce, fruits, such as strawberries, peaches, 
etc. 



Thomas King Chambers, of London, recom- 
mends opium, stating that in some cases it 
seems to diminish the amount of urine, and 
that he had never distinctly traced any harm to 
its action. 

For a tonic he would use iron and strychnia, 
but not cinchona. Iodide of potassium has 
proved useful in his hands, but he adds that it 
was prescribed on purely empirical grounds. 



Thomas Hawkes Tanner, of London, recom- 
mends the following, viz. : 



presceibee's memoranda. 97 

^ . Ferri ammon. cit 3 j. 

Spts. amnion, aromat fl. 3 vj. 

Potass, bicarb 3 ij. 

Infus. calumbas q. s. ad. fl. § iij. 

M. A tablespoonful to be taken twice a day, 
with one tablespoonful of lemon-juice in a little 
water. 

He also recommends the use of opium as fol- 
lows : 

$. Pulv. opii, 

Quiruge sulph aa gr. j. 

For one pill ter die. 

For the purpose of checking the conversion of 
food into sugar, he believes the following pre- 
scription to be useful : 

I£ . Creasoti TTL xx. 

Pulv. aromatici 3 iv. 

Mucilag. acacise q. s. 

M. Divide into twenty pills. One to be taken 
three times a day. 

Dr. Austin Flint states that he has employed 
the bromide of potassium in several cases of dia- 
betes, with favorable results. While he does not 
claim in behalf of this remedy a specific cura- 
tive agency in saccharine diabetes, yet he thinks 
it worthy of extensive trial in order to ascertain 
7 



98 peesceibee's memoeanda. 

whether it should not be classed among those 
remedies which are sometimes useful. 

Dr. J. Y. Dale has found nitrate of uranium, 
given in from one- to two-grain doses, three 
times daily, to be an efficacious remedy in dia- 
betes. 



The fluid extract of ergot has been used with 
beneficial results for diminishing the quantity 
of urine in cases of diabetes — one drachm, or 
half a drachm, three times a day. 

Sulphide of calcium has a good reputation as 
a remedy for diabetes. 



DXARRHCEA. 

The value of oxide of zinc in diarrhoea has 
long been known, but is apt to be overlooked. 
Some recent reports on the subject have bee a 
made by Dr. Tyson, and Dr. Bonamy, of Nantes. 
The formula which the latter uses is : 

]$ . Zinci oxidi gr. liv. 

Soda3 bicarb gr. vijss. 

M. et div. in chart, no. iv. S. — One to be 
taken every six hours. 



In all the cases which he observed, oxide of 
zinc produced a rapid cure of diarrhoea. In 



pkesceiber's memoranda. 99 

fourteen cases observed by Puygautier the cure 
was even more rapid, since in only one case 
were three doses of the medicine required. 
The results are considered to have been more 
satisfactory, inasmuch as in several cases the 
malady had endured from one to many months, 
and other methods of treatment had not pro- 
duced any improvement. Thus, he concludes 
that, although by no means to be held as ex- 
clusive treatment, the employment of oxide of 
zinc deserves to be more generally known as 
useful in diarrhoea. 



$ . Olei ricini fl. 3 iv. 

Mucil. acacias * 3 iv. 

Tinct. opii fl. 3 ij. 

Tinct. rhei arom fl. 3 iv. 

Aquas menthse pip q. s. ad. fl. § iv. 

M. Dose, a teaspoonful for children, in diar- 
rhoea. BOSLEY. 

1}. Tinct. opii, 

Tinct. rhei arom., 

Spts. camphorae aa fl. 3 ss. 

Tinct. cardam. co fl- 3 ij. 

Aquas anisi q. s. ad. fl. 3 iv. 

M. Dose, a teaspoonful for children, in diar- 
rhoea. Swezey. 



100 prescriber's memoranda. 

I£. Ext. rhei fl \ cclvj. 

Ext. ipecac fl \\]. 

Sodae bicarb gr. Dxij. 

Glycerine fl. § xij. 

Aquas menthas pip Oxij. 

M. Dose, } to 1 teaspoonful two or three 
times a day, for children. Squibb. 

$. Mist, cretse fl. 3 v. 

Tinct. catechu, 

Tinct. opii camph aa 3 jss. 

M. Dose, a teaspoonful. 

I£. Plumbi acetat „ gr. xx. 

Pulv. opii gr. x. 

M. Divide into 10 pills. 

5 . Magnes. calcin 3 j. 

Spts. ammon. aromat TT^ xl. 

Tinct. asafcet 3 3. 

Anisette 3 vj. 

Aquas cinnamom q. s. ad. | vj. 

M. S. — Dose, one teaspoonful every half- 
hour till relieved, for a child from three weeks 
to four months old, suffering 1 from flatulent 
diarrhoea. 



prescrtber's memoranda. 101 

5. Tinct. opii camph., 

Syr. rhei arom aa fl. J ss. 

Aquae calcis fl. § ij. 

M. Dose, a teaspoonful for children, in diar- 
rhoea with acidity. Ackermann. 



Squibb 1 s Cholera Mixture. 
]£. Tinct. opii, 
Tinct. capsici, 

Spts. camphorae aa 5 j. 

Chlorof ormi fl. 3 iij. 

Alcoholis q. 3. ad. fl. § v. 

M. Dose, 20-40 minims. 



West's Mixture. 

If. Olei ricini fl. 3 ij. 

Pulv. acaciae, 

Pulv. sacchari aa 3 ij. 

Tinct. opii TI\_ xxj. 

Aquae cinnamom q. s. ad. fl. J iv. 

M. Dose, a teaspoonful for children, in diar- 
rhoea. 



I£. Bismuth subnit., 

Cretae praecipit a a gr. xxx. 

Pulv. opii gr. j . 

M. Divide into 10 powders, for children. 

J. Lewis Smith. 



102 pbesckiber's memokanda. 

1$, . Bismuth subnit gr. iv. 

Pulv. ipecac, co gr. j. 

M. One dose, for children. 

I£ . Bismuth subcarb., 

Pepsini aa gr. ij. 

M. One dose, for children. 

I£. Bismuth, subnit., 

Pepsini aa gr. v. 

M. One dose, for children. Swezey. 



Dr. J. M. Fothergill writes as follows : £ l Look 
at the treatment of diarrhoea. How common- 
ly is an astringent mixture containing an opi- 
ate prescribed without further reflection ? Of 
course, in a great many cases, immediate effects 
are produced which are gratifying to the pa- 
tient. Yet, in a certain percentage of cases, 
such a plan is not only not successful, but does 
harm. In those cases where there is an offend- 
ing mass in the intestines setting up a secretion 
to sweep it away — but where the secretion is 
set up too low for its removal — there is a teas- 
ing diarrhoea, a persistent desire to go to stool, 
with small, ineffective motions, affording no re- 
lief. Here the ordinary diarrhoea mixture only 



pkescriber's memokanda. 103 

does harm, and what effect it has is to arrest a 
spontaneous reflex act often of a beneficial 
character. The proper treatment is to admin- 
ister a dose of castor- oil, or, better still, a scru- 
ple of rhubarb in powder, by which secretion is 
set up above the offending' mass and it is swept 
away, after which the diarrhoea ceases. The 
secondary action of rhubarb in constipating the 
bowels renders it the agent par excellence for 
the treatment of this form of diarrhoea. The 
astringent and opium treatment of diarrhoea is 
equally or still more out of place in those cases 
where there is a fecal mass lodged or accumu- 
lated in the rectum. Every surgeon who sees 
much of diseases of the rectum has instructive 
stories to tell of cases where the patient has 
consulted a large number of eminent physicians, 
without avail, for a persistent diarrhoea. The 
usual mixtures, in great variety, are prescribed, 
without effect. At last the persisting tenesmus 
drives the patient to a rectal surgeon, who, on 
examination, finds a solid mass in the bowel, 
around and past the sides of which the thin 
fecal motion passes. Here diarrhoea is the only 
possible means by which the bowels can be 
emptied ; and it is fortunate that the astrin- 
gent mixtures are inoperative to arrest this 
diarrhoea, else the patient's condition would in- 



104 prescriber's memoranda. 

deed be a serious one. The mass is removed, 
and then the diarrhoea spontaneously ceases." 



]£. Tinct. opii, 
Tinct. capsici, 
Tinct. rhei arom., 
Spts. menthas pip., 
Spts. camphoras aa equal parts. 

M. Dose, 20-40 minims. Ruschenberger. 

I£. Tinct. capsici fl. § j. 

Tinct. catechu, 
Tinct. kino, 

Tinct. kramerias. aa fl. § iv. 

Tinct. opii fl. § iij. 

Spts. menthas pip fl. § ij. 

Spts. camphorae, 

Aquas aa fl. § ix. 

M. Dose, 30-60 minims. 



Hope's Mixture. 

E . Acid, nitrici Tf^ viij. 

Tinct. opii 7^x1. 

Aquas camphoras fl. § viij. 

M. Dose, a tablespoonf ul. 



peescbibek's memoranda. 105 

Modification of Hope's Mixture (Thomson). 

^ . Acid, nitric, dil 3 ij. 

Tinct. camph., 

Tinct. opii aa 3 j. 

Syr. zingiber 3 iv. 

Aquae menthas pip ad. § vj. 

M. S. — Tablespoonful doses to be used after 
a cathartic. 

]£. Tinct. opii, 

Tiuct. capsici, 

Spts. carnphoras, 

Spts. menthae pip aa fl. 3 ij. 

Aquae fl. | j. 

M. Dose, a teaspoonful. 

I£ . Bismuth subcarb gr. ij. 

Acid, tannici gr. j. 

Pulv. ipecac, co gr. J. 

M. One dose, for children, in diarrhoea. 

Yf,. Bismuth subnit., 

Sodas bicarb., 

Pulv. sacchari, 

Pulv. acacias, 

Pulv. zingiber aa equal parts. 

M. Dose, a tablespoonful, for adults. 

Wheelock. 



106 prescriber's memoranda. 

5 • Tinct. calumbse 3 xv. 

Tinct. opii deodor 3 j. 

M. S. — A teaspoonful in a wineglassful of 
water, before meals. Bartholow. 

This formula is best adapted to a condition 
such as the following, viz. : soon after taking 
food, pain referable to the small intestine, nau- 
sea, loose evacuations containing undigested ali- 
ments, and followed by weakness and depres- 
sion. 



Coto-bark has proved itself very efficient in 
diarrhoea, but especially in that of phthisis. 
May be given in form of powder or fluid ex- 
tract. 



For diarrhoea due to deficient nerve -supply 
to the mucous membrane (summer diarrhoea), 
salicine, gr. v., every four hours. Place the 
patient in bed. A. A. Smith. 



^ . Bismuth subnitrate 3 j. 

Morph. sulph gr. j. 

M. et div. chart, no. xii. S. — One every six 
or eight hours, in simple chronic intestinal 
catarrh. Clark. 



prescriber's memoranda. 107 

Dr. A. A. Smith, to clear the bowels of curdy 
masses due to acidity in the diarrhoea of chil- 
dren, prefers the following to castor- oil : 

$ . Pulv. rhei rad gr. xv. 

Sodae bicarb gr. xxv. 

Aquas menthae pip § ij. 

M. S. — 3 j. for a child from two to four 
years old. 

This is to be followed by chalk mixture. 
In the diarrhoea of dentition he first lances the 
gums, and then gives : 

3 . Sodae bromid 3 ss. 

Mucil. acaciae, 

Aquae pur aa. q. s, ad. § ij. 

M. 3 ]*• every three hours, for a child between 
six months and a year old. 



Dr. Alexander Hutchins has treated in private 
practice, in three months, twenty-seven cases of 
serous diarrhoea in infants, ranging from two 
months to two and one-half years of age, using 
one drug only ; some of the cases were seen but 
once, many only twice, and none above four 
times ; in all the disease was promptly and 
permanently controlled. He says : 

41 The form in which I have used the calcium 



108 pkesckibek's memoranda. 

salt would be represented in a formal prescrip- 
tion thus : 

" ]£ . Acid salicylic gr. xxij. 

Cretas prseparat gr. viij. 

" Misce accurate. Divide in chart, no. vj. (gr. 
v.), vel. no. x. (gr. iij.). S. — One every two to 
four hours." 

" In the process of mixing the powder an effer- 
vescence occurs, which alarms the attendant, but 
which the prescriber recognizes as due to the 
release of carbonic acid in the formation of the 
new salt. Also, in the process of mixing, a pun- 
gent odor of chlorine is not infrequently per- 
ceived. One physician informs the writer that 
this is probably due to the impurity of the pre- 
pared chalk. The prepared chalk of the shops 
is a residuum of the manufacture of chlorinated 
soda, and if the chalk be imperfectly washed 
an odor of chlorine will be perceived. This is 
an impurity of the drug, and should be avoided." 



DIPHTHERIA. 

Dr. R. Carney and Rokitansky speak highly of 
chloral as a local application in this disease. 



Dr. John A. Erskine Stuart says that sulphur 
precipitatum (milk of sulphur) used as a topical 



pkesceeber's memokanda. 109 

application, has been very useful in his prac- 
tice in seven cases of diphtheria, either blown 
on through a quill, or stirred up with water and 
swabbed on. It causes, almost immediately 
after application, blackening of the membrane 
and detachment of it. To show its rapidity of 
action, six of these cases only required an av- 
erage of 2.6 visits. In opposition to the views 
of Dr. Oertel, and of Dr. Braithwaite, and the 
gentleman appointed to report (the two latter 
criticising his first notice of the subject in the 
Practitioner of April, 1870), he says : "I am of 
opinion that the action of sulphur in this dis- 
ease is a specific action, not a mere c scouring 
powder ' (Dr. Oertel), nor that its action is princi- 
pally by friction. I use no friction. I have 
found the application of carbolic acid, sulphur- 
ous acid, and solution of muriate of iron, in 
equal parts, a pretty sure remedy locally applied, 
but deleterious from making fresh abrasions a 
fitting field for the growth of new membranes. 
The use of strong caustics is to be strongly de- 
precated. The sulphur treatment is easily used, 
and is not at all disagreeable to the patient." 



Dr. Larue recommends the followicg as a 
gargle. In the case of an infant the solution may 
be applied to the throat with a brush. 






110 prescriber's memoranda. 

^. Salicylic acid, 

Biborate of soda aa 3 ij. 

Carbolic acid fl. 3 j. 

Water J iv. 

M. If hemorrhage occur in the throat, equal 
parts of tannin and borax is serviceable. Solu- 
tion of chlor. potass, is useful in many cases. 
Feed your patients on good, nourishing food 
from the beginning. 



M. Yidal recommends the topical use of tar- 
taric acid in diphtheria. In his opinion it is 
necessary to make use of topical agents against 
the false membrane, for it has a great tendency 
to spread. He employs the following formula: 

1$. Acid tartar 2 parts. 

Glycerinse 3 parts. 

Aquae menthse 5 parts. 

M. 

The acid acts upon the false membrane, con- 
verting it into a gelatinous mass, and favors its 
expulsion. 



Chlorine water has been highly recommended, 
and the following is a formula for its prepara- 



presckeber's memoranda. Ill 

tion : Put sixty grains of finely powdered chlor- 
ate of potash in a strong pint bottle, pour upon 
it two drachms of strong muriatic acid, close the 
mouth of the bottle until the violent efferves- 
cence ceases, add one ounce of water and shake 
well, add another ounce and shake again, and 
so on until it is filled ; keep in a dark place, and 
tightly corked. One or two tablespoonfuls may 
be taken frequently, according to age ; an adult 
may take a pint in twenty-four hours. 



Dr. A. Erichsen recommends strongly the 
cyanide of mercury in minute doses, in diph- 
theria. Of twenty- five cases treated, only three 
proved fatal. With its use the membranes be- 
came thinner and less adhesive, and even where 
they had extended into the larynx, threatening 
obstruction, they had separated, and the larynx 
again became free. The writer believes that 
mercury shortens the duration of the diphtheri- 
tic process, and that this preparation does not, 
like the others, disturb digestion or nutrition. 
To syphilitic children it may be given for 
months without disturbance, in doses of -£g of a 
grain three times daily. The ordinary dose for 
a child under three years of age is -^ of a grain, 
once every hour or two. 



112 presceiber's memoranda. 

The following is the formula : 

1^ . Hydrargyri cyanatis gr. j. 

Aquae distill 5 v j- 

Svr. simplicis § ss. 

M. S. — Half or a whole teaspoonful every 
hour. 



Dr. Frickelton gives the following treatment 
of diphtheria, which has been very successful 
in his hands : 

3£ . Potass, chlor 3 j. 

Acid, hydrochlor. dil 3 ij. 

Tinct. f erri. chlor 3 iij. 

Aquae ad. § viij. 

M. S. — A teaspoonful every three hours. No 
fluid to be taken with the medicine, nor within 
fifteen minutes after taking it. As an applica- 
tion to the throat in severe cases, he uses one 
part tincture of iron to two of the above mix- 
ture, applied with a brush. If the fever is very 
high, he adds tincture of aconite to the mixture. 



^ . Potass, chlor 3 ss. 

Tinct. ferri chlor fl. 3 j . 

Aquae q. s. ad. fl. I j. 

M. Dose, one teaspoonful. 



prescriber's memoranda. 113 

^ . Natr. benz. pur gr. lxxv. 

Aquge dist., 

Aquse menthae pip aa 3 x. 

Syr. aurant. cort 3 ij» 

M. Infants under one year, 3 ij. every hour. 
Children from one to thres years, § ss. every 
hour, the amount of benzoate in the prescrip- 
tion being increased from 75 to 110 or 125 
grains. 

From three to seven years of age, the amount 
in the prescription is increased to 3 ij. to 3 iij., 
and for adults from 3 iij. to 3 vj. 

The throat is to be powdered with the ben- 
zoate three or four times daily, and a gaigle of 
the strength of five per cent. used. Letzerich. 

]£. Tinct. guaiaci, 

Glycerines equal parts. 

M. S. — Teaspoonful every one, two, three, or 
four hours. 



DYSENTERY. 

Thirty grains of ipecac made into bolus or 
suspended in orange-syrup. No fluid is allowed 
for one hour before and three hours after the 
dose has been taken. Often cures also chronic 
diarrhoea of long standing. An emetic action 
is not desired. 



114 prescriber's memoranda. 

Deb finds ixora dandanea a very valuable 
remedy in cases of dysentery, when adminis- 
tered in the early stages of the disease. He 
uses a tincture of the fresh root (four ounces 
to the pint of alcohol), in doses of two to four 
grammes (one-half to one drachm). It causes 
no nausea, and, moreover, has an aromatic, 
agreeable taste. 

Dr. Robert M. King speaks highly of the 
use of ergotin hypodermically, or in pill-form, 
as follows : 

1£. Ergotinse 3j. 

Ext. nucis vom. gr. v. 

Ext. opii aq gr. x. 

M. Ft. pil. no. 20. S. — One every six hours. 



DYSMENORRHEA. 

The following combination is well spoken of 
by Dr. Pattee, in ovarian dysmenorrhcea : 
$. Tinct. pulsatillae, 
Tinct. actese albae, 

Tinct. cimicifugae aa gtt. xv. 

Aquas fl. § iv. 

M. S. — A teaspoonful three or four times a 
day. 



pkescribeb's memoranda. 115 

Dr. Atthill, in his Clinical Lectures, advises 
from three to ten drops of Fowler's solution in 
dysmenorrhoea, combined with ten- drop doses 
of tincture of digitalis, three times a day, be- 
tween the periods. He has often obtained the 
best results from this treatment. 



I£. Tinct. nucis vom., 

Sol. Magendie 5a 3 j. 

Ext. belladonnse fl gtt. xv. 

M. S. — Take five drops three times a day be- 
tween the periods. 



DYSPNCEA. 

Berthold gives an account of several cases 
of severe convulsive asthma where quebracho 
seemed to . produce a very happy effect in dysp- 
noea. In one case, a gentleman of sixty-five 
was found in a violent attack, pulse 108, res- 
piration 64- A teaspoon ful of the tincture was 
given every hour, and at the end of three hours 
the respiration was reduced to 30, and the pa- 
tient rapidly recovered without other medicine. 
In some fourteen other cases a similar happy 
result was obtained, though not always with the 



116 peescbibeb's memoeaxda. 

same promptitude. In the case of a lady of 
sixty, suffering from mitral insufficiency, with 
stenosis and frequent attacks of frightful dysp- 
noea, where digitalis had failed, quebracho gave 
relief. 

The subcutaneous use of morphia often proves 
of great service. Also dry cups. 

For cardiac dyspnoea, Professor See recom- 
mends : 

1£ . Potass, iodid 3 vss. 

Syr. cort. aurant § xijss. 

Dose, two to four tablespoonfuls per day. 
Each spoonful must be dissolved in a tumbler 
of water. 

Patients suffering from heart disease take 
iodide of potassium very well — better than other 
patients. The following are the drawbacks of 
this drug : 

1. Bleeding from the buccal membrane, or 
bronchitis and haemoptysis in tuberculous pa- 
tients. (Phthisis is, therefore, a counter-indi- 
cation for the use of iodide of potassium. ) 

2. Loss of flesh ; in fat individuals this is to 
be regarded as a favorable symptom. 

3. Loss of strength ; in such cases the treat- 
ment must be suspended at once. 

4. Loss of appetite. 



prescriber's memoranda. 117 

Opium may be added to iodine, in order to 
prevent the evil effects of the latter : 

I£ . Potass, iodid 3 vss. 

Syr. cort. aurant § xijss. 

Ext. thebaic gr. j.-jss.- 

Dose, from two to four spoonfuls per day. 
For the ext. thebaic, the syrup papaveris may 
be substituted : § jss. 

Opium is given here with a view of making 
the iodine more easily tolerated, and of dimin- 
ishing the cough, which greatly inconvenien- 
ces the patient. 

Another very useful combination is that of 
digitalis with iodine, as the one has a soothing 
influence on the dyspnoea by acting on the lungs, 
and the other increases the action of the heart 
and modifies the arterial tension. The follow- 
ing formula will be found to answer well : 

]£ . Julep gommeux | iij. 

Potass, iodid gr. xv. 

Tinct. digit. . . .* 3 x. 

Or the following formula : 

3. Ext. gent gr. j. 

Pulv. f ol. dig gr. jss. 

To take one pill three times daily, together 
with the sol. of iodine, which we have men- 
tioned above. In cases where patients cannot 



118 prescribeb's memobanda. 

take digitalis, chloral will bo found to be a good 
substitute. Thus : 

I£ . Julep gommeux § iv. 

Potass, iodid 3 ss. 

Chloral hydrate 3 j. 

To be taken every two hours during the day. 



DYSPEPSIA. 

3 . Sodas bicarb 3 iv. 

Tinct. zingiber fl. 3 ij. 

Tinct. gent, co fl- 3 j- 

Aquas fl. 3 v. 

M. Dose, two teaspoonfuls in atonic acid dys- 
pepsia. 

3 . Sodse bicarb gr. xx. 

Acid, carbol .' gtt. ij. 

x\cacias. 1 

Sacchari aa q. s. 

Spts. lavandulas co fl. 3 ij. 

Aquas q. s. ad. fl. § j. 

M. Dose, a teaspoonful two hours after 
meals, in dyspepsia with fermentation. 



prescriber's memoranda. 119 

$ . Sodas bicarb 3 j. 

Pulv. rhei § ss. 

Spts. inenthas pip fl. 3 ij. 

Aqu.se q. s. ad. fl. § iv. 

M. Dose, a tablespoonful in acid dyspepsia. 



Dr. Willis recommends, in that form of dys^ 
pepsia attended with rapid fermentation of food 
and evolution of gas soon after a meal, fifteen 
to twenty drops of chloroform in a little sweet- 
ened water. It expels the gases from the stom- 
ach in a few minutes, and averts fermentation 
promptly, without any unpleasant effects. 



Anise Cordial. 

]£. Infusi anisi ( 3 ij. to Oj\), 

Genevae (gin) aa fl. ^ j. 

M. Dose, half a teaspoonful, in cases of flat- 
ulence and colic. 



I£. Gum camphor, 
Pulv. ginger, 
Capsicum aa gr. j. 

M. et div. in pil. no. vj. S. — One p. r. n., for 
gastric and intestinal flatus. 



120 prescriber's memoranda. 

]£. Tinct. gent, co., 

Ext. valeriani fl aa. § iv. 

Tinct. nucis vom 3 j. 

Sodas bicarb 3 iij. 

Acid, carbol gtt. x. 

M. S. — One teaspoonful after meals. The 
carbolic acid is added to prevent acid fermenta- 
tion in the stomach. It also serves to preserve 
the mixture. 



Dyspepsia, with Constipation. 
1$. Sulphur, sublim., 
Potass, bitart., 
Sodas bicarb., 

Sodas et potass, tart aa equal parts. 

M. Dose, a tablespoonful mixed with sweet- 
ened water. Maxwell. 



I£. Bismuth, subnit., 

Sodas bicarb. , 

Cretas prasparatas aa 3 j. 

M. Divide into 12 powders. Trousseau. 



Where there is torpor of digestion joined with 
very marked sympathetic nervous disturbances, 
Dr. Pepper uses the following formulas : 



presceibeb's memoranda. 121 

If. Sodae bicarb 3 iij. 

Acid, hydro-cyan. dil. . . . r gtt. xlviij. 

Tinct. valeriani fl. 3 j. 

Syr. zingiber fl. § ij. 

M. S. — A teaspoonful thrice daily, in water. 

If. Quinise sulph gr. xvj. 

Strychnia? sulph gr. \. 

Acid, muriat. dil fl. 3 jss. 

Syr. zingiber q. s. ad. fl. § iv. 

M. S. — Two teaspoonfuls in water, after 
meals. 



Where there is marked hepatic disturbance, 
the following prescriptions are excellent : 
$„ Acid, muriat. dil fl. 3 ss. 

Tinct. nucis vom fl. 3 ss. 

Infus. gent, co q. s. ad. § iv. 

M. S. — A teaspoonful in water, after meals. 

I}. Bismuth, subnit. . , 3 jss. 

PepsinaB 3 jss. 

Strychniae sulph gr. j. 

Tinct. cardam. co. . . .q. s. ad. fl. 3 iv. 

M. S. — A teaspoonful thrice daily, in water. 
If there is much flatulence, an increase is made 
in the quantity of bismuth and pepsine. If the 



122 prescriber's memoranda. 

case be merely one of gastric atony, the amount 
of strychnia is increased. 

I£ . Tinct. capsici 3 v. 

Pulv. cubeb 3 ij. 

Tinct. cinchonas 3 iv. 

M. S. — A teaspoonful t. i. d., for nausea and 
gastritis of alcoholism. 

1$. Ext. nucis vom gr. v. 

Sodas bicarb., 

Rhei pulv aa 3 j. 

M. et div. in pil. no. xx. S. — One t. i. d. 

Delafield. 

1$. Bismuth, subnit., 

Magnesias carb aa gr. xvj. 

Acid, hydrocyan. dil 7T}_ v. 

Aquas § iv. 

M. Dose, 3 ij. for a child three years old, in 
flatulent gastrodynia and gastralgia. 

I^. Bismuth, carb gr. j.-ij. 

Magnesias carb gr. iij. 

Tinct. hyoscyam TT^ v. 

Infus. rhei 3 ij. 

In atony and irritability of the stomach. 

Ellis. 



pbescribek's memoranda. 123 

3?. Pepsini gr. lxiv. 

Acid, hydrochlor fl. 3 ss. 

Glycerines fi. § jss. 

Aquae fl. | ijss. 

M. and filter. Dose, tablespoonful in cases 
of slow digestion. 

1$. Cimicif ugaa § j. 

Gentian as, 

Zingiberis aa 3 j. 

M. et ft. chart, no. j. S. — Put in a pint of 
boiling water, and when cold, strain ; take a 
wineglassful three times a day. Tonic. 



I£. Potass, bromid § j. 

Ferri sulph. exsic 3 ss. 

Calumbse, 

Zingiberis aa 3 iv. 

M. et ft. chart, no. j. S. — Put in a pint of 
boiling water, and when cold, strain ; take a 
tablespoonful three times a day, in nervous 
dyspepsia. 



DROPSY. 

Dr. Thomas, of Kentucky, has found Ascle- 
pias Syriaca of value in dropsy, without refer- 



124 pkescbibeb's memokanda. 

ence to the nature of the cause, but especially 
is it serviceable in engorgement of the liver, 
being in many cases superior to either calomel, 
leptandrin, or podophyllin. In no case, when 
used in doses which come short in effect of 
causing vomiting, does this remedy fail to cause 
profuse diaphoresis, and remove dropsical accu- 
mulations. He employs the following formula : 
1^. Strong decoction of asclepias 

Syriaca fl. § xij. 

Decoction of phytolacca de- 

candra fl. § iv. 

Whiskey fl. § vj. 

White sugar fl. | iv. 

M. From one-half teaspoonful to two tea- 
spoonfuls thrice daily, according to the age of 
patient and effect produced. 



3$. Teaspoonful doses of carbonate of iron, 
with one pint of marsh- mallow tea, three times 
a day. 



1$. Inf us. digitalis § ss. 

Potass, citras gr. xv. 

M. S. — Every three or four hours. 



Poultices of digitalis leaves, with tinct. apo- 



presckibeb's memoranda. 125 

cynum. cannab., gtt. x. every two hours, are 
also serviceable. 



V f . Broom-tops, 
Juniper berries, 

Dandelion root aa J ss. 

Aquas Ojss. 

M. Boil to one pint. Dose, one teaspoonful. 
Two drachms of the bitartrate of potassse can 
be substituted for the dandelion. Dickinson. 



EARS, Inflammation of. 
A round piece of wicking may be used to 
cleanse the ear, instead of a syringe. It may be 
introduced by the patient himself. A gentle, 
rotary motion will carry it to the bottom of the 
meatus, where it quickly absorbs the pus. This 
is to be repeated until the ear is cleansed, and 
a piece is left in situ. It may be medicated 
with an alkaline solution or with salt water. 



3 . Tinct. acid, hydrobromic 3 iij. 

Syr. limon ad. § ij. 

M. 3 t. i. d., with inhalations of benzole 
where the tinnitus is of a knocking, pulsating 



126 prescreber's memoranda. 

character ; of no service where it is of a roaring 
character. Fox. 



ECZEMA. 

]£ . Iodinii crystal § ss. 

Acid, carbol. crystal | j. 

Mix with gentle heat. Dilute with equal 
quantity of glycerine for the first application. 
A camel' s-hair brush, or glass rod may be used 
to apply the remedy. It is indicated where 
there is intense itching, with probable presence 
of parasites. Bellamy. 



3 . Hydrarg. ammoniat gr. xv. 

Glycerini amyli § j. 

M. MULLER. 

$ . Liq. plumb, subacetat § j. 

Glycerini § ss. 

Cherry-laurel water § iijss. 

M. S. — Lotion. Bartholow. 

This will be found to be very serviceable in 
eczema, characterized by great heat and red- 
ness and excessive discharge. 

In this same condition Dr. Tilbury Fox re- 
commends the following : 



prescriber's memoranda. 127 

I£ . Acid. nit. dil 3 ss. 

Plumb, acetat gr. v. 

Aquae % vj. 

M. S.— Lotion. 

^ . Pulv. alum | ij. 

Pulv. zinci oxid 3 iv. 

Pulv. rad. iridis § ij. 

Pulv. amyli 1 viij. 

M. S. — Apply locally. Hebra. 

^ . Olei cadini ^ ss. 

Glycerines 3 j. 

Ung. diachylon § ijss. 

In squamous eczema with thickening of the 
skin. G. H. Fox. 



EMPHYSEMA. 

B. Potass, chlorat 3 jss. 

Tinct. belladonnas § jss. 

Ext. pruni Virg. fl. , 

Tinct. cinchonas co aa § ij. 

M. S. — A dessertspoonful four times a day. 

Da Costa. 



128 prescriber's memoranda. 

Where the emphysema is accompanied by 
chronic bronchitis and loss of appetite, Dr. Da 
Costa has found the above prescription the most 
efficient. He advises also that dry cups be ap* 
plied to the chest night and morning. 



ENDOCARDITIS. 

It is the rule to give tonics as soon as possi- 
ble and to get the patient up, but the proper 
plan of treatment is to keep the patient flat in 
bed for some days after all evidence of active 
mischief has passed away. The growth of con- 
nective tissue in the valve-curtains, which is 
lighted up by the inflammatory storm that 
passes over the endocardium, persists some time 
after the endocarditis itself is over, and it is the 
mutilation caused by the contraction of the 
neoplasm which is chiefly to be dreaded. Con- 
sequently the true line of practice is to reduce 
the strain upon the inflamed valve -curtains by 
complete rest and the administration of agents 
which lower the blood-pressure within the heart 
and arteries. The more the connective- tissue 
growth can be limited at the outset, the less 
the future mutilation of the valves. 

J. MlLNER FOTHERGILL. 






presckibek's memoranda. 129 

EPIDIDYMITIS. 

Tobacco and linseed-meal poultice at night. 
Ij,. Ung. belladonna?, 

Ung. stramonii. aa 3 ij. 

M. External use. 
and 

I£ . Tinct. cantharides gtt. vj. 

Ext. Pulsatillas fl gtt. x. 

Aquas § jv. 

M. S. — Teaspoonful every three hours. 



F. J. Bumstead, M.D., recommended that 
absolute rest in a recumbent posture should be 
enjoined immediately upon the first symptoms 
of the accession of an epididymitis. The bowels 
should be cleared by a cathartic, such as citrate 
of magnesia. If there is much febrile disturb- 
ance, give aconite, support the inflamed testi- 
cle, and smear it with : 

$ . Ext. belladonnas 3 ij. 

Glycerinae § ss. 

Aquas 3 j. 

M. Moisten also a piece of lint with the 
same, and apply constantly. 

When fluid is found in the tunica vaginalis, 
resort to the multiple punctures recommended 
9 



130 prescriber's memoranda. 

by Velpeau. By so doing you will give imme- 
diate relief and arrest the progress of the dis- 
ease. This treatment, to which may be added 
sedatives internally in certain cases, and in 
cases of delayed resolutions careful strapping 
of the testicle, comprises about all the routine 
treatment of this author, who was a well-known 
authority in venereal diseases. 



EPILEPSY. 

Dr. C. M. Shields recommends : 

^ . Root of r/hite peony * x. 

Boiling water 1 gallon. 

Boil to two quarts and filter. Take one ounce 
three times a day. 

^. Sodas bromid., 
Potass, bromid., 

Ammon. bromid aa 3 iij. 

Potass, iodid. , 

Ammon. iodid aa 3 jss. 

Ammon. carb 3 j. 

Tinct. calumbae fl. § jss. 

Aquas q. s. ad. fl. § viij. 

M. Full dose, one and a half drachms be- 
fore each meal, and three drachms at bedtime. 
Brown- SJsquard. 



prescriber's memoranda. 131 

5 . Potass, bromid gr. xxv. 

Tinct. belladonnas T^ v. 

Aquae q. s. ad. fl. 3 j. 

M. One dose, to be taken thrice daily. 

I> . Potass, bromid gr. xxx. 

Ext. conii 11 Tl\ xv. 

Aquas q. s, ad. fl. 3 j. 

M. One dose, to be taken thrice daily. 

]£. Potass, bromid., 

Ammon. bromid aa gr. xxx. 

Ext. ergotae fl 7T[ xv. 

M. One dose, to be taken thrice daily in cases 
characterized by considerable maniacal excite- 
ment following the attack, indication of cerebral 
congestion, and especially where hemorrhage is 
feared. Charles K. Smith. 



ERECTILE TUMORS. 

Verneuil recommends injections of small 
quantities of the following solution : 
$. Distilled water, 

Perchloride of iron aa § j. 

Chloride of sodium 3 j. 



132 pkesckibee's memokanda. 

Several punctures may be made, and a few 
drops injected at each, the skin surrounding 
the tumor being firmly pressed by the ring of a 
key, to prevent absorption taking place bef oro 
the clot is formed. 

See also Naevi. 



ERYSIPELAS. 

Dr. C. G-. Rothe has been accustomed for 
years to employ painting of the inflamed sur- 
face and its surrounding parts, every two hours, 
with a mixture of carbolic acid and oil of tur- 
pentine : 

Jf, . Acidi carbol. 1 part. 

Spts. vini 1 part. 

Olei terebinthinas 2 parts. 

Tinct. iodini 1 part. 

Glycerinse 5 parts. 

He has had occasion to be well satisfied with 
its success. 

The applications are entirely painless, and do 
not even excite heat of the skin. Commonly 
this is found wrinkled and pale on the second 
day. 

Dr. A. Jacobi recommends the local applica- 
tion, all around the edges of the erysipelas, of 
crystallized carbolic acid 1 part, and oleic acid, 



pbesceiber's memoranda.' 133 

8, 10, 12, or 14 parts. The inunction must be 
repeated every ten or twelve minutes, each in- 
unction lasting- from three to four minutes, and 
continued until the erysipelas ceases to spread. 



Dr. John E. Brackett uses the following hy- 
podermically in erysipelas : 
I£. Acid, carbol., 

Alcohol aa 3 ss. 

Aquae dist § ij. 

M. 

Of this solution he injects five syringefuls in 
the hand and arm at points where the redness 
is most intense, 



5 . Morphias sulph gr. iij. 

Ferri sulph 3 ij. 

Vaseline § j. 

Apply over inflamed part on lint, and bandage 
tightly and evenly. 



EYES, Inflammation of. (See also Conjunc- 
tivitis.) 

^ . Morph. sulph gr. iij. 

Zinci sulph g-r. ij. 

Aquas dist § j. 

M. S. — Apply two drops directly to the eye 
every three hours. 



134 prescriber's memoranda! 

Prof. Meigs recommends the following for 
ophthalmia neonatorum : A solution of nitrate of 
silver (three-fourths of a grain to the ounce). 
This was injected under the lids twice a day. 
For the lids themselves he employed the fol- 
lowing : 

I£ . Soda3 boratis gr. xij. 

Zinci sulph gr. j. 

Aquce camphoras fl. 3 j. 

Aquas dist fl. § j. 

M. S. — To be applied to the lids two or 
three times a day. 

Inject between the lids every half-hour a 
solution of alum (from five to eight grains to 
the ounce), the strength of the solution to be 
gradually diminished as the case gets better. 

Dickson. 



FEET, Perspiration of the. 

Dr. Gordon says that systematic faradization 
of the parts control excessive perspiration of 
the hands and feet. 

Dr. F. C. Ainsworth recommends the follow- 
ing : bathe the feet every morning with warm 
soap and water, dry them gently with a towel, 
and, while they are yet moist enough to cause 



prescriber's memoranda. 135 

the powder to partially adhere, apply freely this 
mixture to the whole foot : 

J£ . Pulv. alum exsiccati § iij. 

Acid, salicyl 3 jss.-iij. 

M. Change the shoes and stockings daily. 

Dr. Charles Ambrook recommends a one per 
cent, watery solution of permanganate of pot- 
ash. Bathe the feet night and morning, and 
oftener if necessary. The discoloration of the 
skin is temporary. 

A strong solution of boracic acid has been 
used with good results. 

]J . Acid, salicyl gr. xv. 

Amyli gr. cl. 

Talci I iij. 

M. For sweating feet. Kohnhorn. 



Dr. Ortega prescribes baths of a solution of 
chloral — 1 in 50 — and wrapping the feet in a 
cloth dipped in a similar solution. 



A powder, composed of 3 parts salicylic acid 
and 87 parts of magnesium silicate, is used in 
the German army as a remedy for sweating of 
the feet. 



136 prescriber's memoranda. 

FEVER, Milk. 

I£ . Tinct. aconit. rad gtt. xx. 

Antimon. et potass, tart g-r. ij. 

Spts. etheris nitrici, 

Syr. simplicis aa § j. 

Aquas aurant. flor 3 ij. 

M. S. — A teaspoonful in a wineglassful of 
sugar and water, every two hours. 

Fordyce Barker. 

In addition to this, Dr. Barker gives nutritious, 
easily digested food ; applies the child to the 
breast as soon as the patient has recovered from 
the exhaustion of labor ; attends to the state of 
the bowels; gives a diaphoretic anodyne, and 
has the nurse rub the breasts from circum- 
ference to nipple with warm sweet oil every 
three hours. 



FISSURE, Anal. 

Instead of employing forcible dilatation, Dr. 
Hamon applies to the fissure, with a camel's-hair 
brush, a solution consisting of one part of chlo- 
roform to two parts of alcohol. Two or three 
applications, at intervals of two or three days, 
usually suffice to effect a cure. The first appli- 



prescrtber's memoranda. 137 

cation is very painful, but each subsequent one 
becomes less so. 



FRECKLES. 

$ . Hydrarg. bichlor gr. vj. 

Acid muiiat. dil 3 j. 

Aquas § iv. 

Alcohol, 

Aquas rosae aa § ij. 

Glycerines § j. 

M. Apply at night and wash in the morning 
with soap and water. 

Take of finely powdered sulphophenate of zinc, 
one part ; oil of lemon, one part ; pure alcohol, 
five parts ; collodion, forty-five parts. Mix 
well together by trituration. This has been 
found efficacious as a local application against 
freckles and other slight skin diseases. 



FURUNCLES and other Suppurative Af- 
fections, 

3 • Calcii sulphide gr. x. 

Pulv. sacch. alb gr. xxx. 

M. et div. chart, no. xx. S. — One four times 
a day. 



138 prescriber's memoranda, 

GLEET. 

The passage of a well-oiled steel sound every 
fourth day. Slitting the meatus, if it is narrow. 

B . Pulv. cantharidum gr. £. 

Olei terebinthinae gtt. v. 

M. S. — One pill, thrice daily, in obstinate 
gleet. 

This is reported as very efficient in old and 
refractory cases. Should strangury be brought 
on, discontinue for a day or so. 



3£ . Acid, tannici gr, x. 

Bismuth, subnit 3 ij. 

Aquae rosse fl. 1 vj. 

M. S. — Shake and use three times daily, as 
an injection. Maury. 



GONORRHOEA. 

Lafayette Mixture. 
I£. Balsam, copaibae., 

Spts. aetheris nitros aa § j. 

Liq. potassae 3 ij- 

Ext. glycyrrhizae § ss. 

M. et ad. : 

Olei Graultheriae gtt. xx. 

Syr. acacias ad. § vj. 

M. S. — Tablespoonful after each meal. 



prescriber's memoranda. 139 

Reverdiri's Mixture for Blennorrlioea (first few 
days). 

$ . Pounded sugar § iij. 

Bicarbonate of soda 3 v. 

Benzoic acid 3 jss. 

Essence of lemon q. s. 

M. Teaspoonful six times a day, in a tumbler 
of water. Follow by injection and balsam co- 
paibae. 

^ . Gurjun balsam 3 j. 

Gum arabic 3 j. 

Infusion of anise 3 x. 

Syr. of catechu 3 iij. 

Syr. of poppies , 3 iij. 

M. Half to be taken before breakfast, half 
before dinner ; after each a glass of wine. 

The pain ceases in three or four days, the 
discharge diminishes ; cure results in ten days, on 
the average. In vaginitis a cure is obtained in 
six to ten days. Vidal. 



Dupouy uses from sixty to seventy-five grains 
of Kava root, a species of pepper from Oceanica, 
which is grated and macerated in a quart of water 
for five minutes. It is filtered and taken in two 
doses in the course of the day, either before or 
after eating, until a cure i3 effected. Twenty 



140 pkescbiber's memoranda. 

minutes after the first dose there is a desire to 
urinate, but there is less burning and the urine 
is clearer. Cure in from ten to twelve days, 
without digestive disturbance. 

Put the patient in bed. Give him mucila- 
ginous drinks. Soak the penis twice a day in 
hot water for fifteen minutes. In a majority of 
cases cure will be effected within ten days. 

GOITRE. 

Dr. Flashar reports the case of a young 
country-girl of seventeen, who had a large ex- 
ophthalmic goitre, sometimes accompanied by 
palpitations. He used, without results, the sub- 
cutaneous injections of ergotine. This remedy 
was then injected into the parenchyma of the 
goitre, and after three injections the tumor dis- 
appeared entirely, and has not returned after 
many years. The first injection was followed 
by a severe pain in the side of the neck and 
head, with . sensation of intense heat in the 
head, ear, and jaw 3 and redness of these parts. 

5 • Ammon. chlorid 3 vss. 

Syr. simpl 5 ss * 

Aquae cinnamomi § iv. 

M. S. — Take 3 j. three times a day. Has been 
very successful in effecting a cure. Stevens. 



peesckibee's memoranda. 141 

Injections of absolute alcohol into the sub- 
stance of the goitre once a week or two weeks 
— fifteen to twenty drops — have produced good 
results. Continue for several months. 



GOUT. 

LallemancCs Specific. 
^. Ext. colchici acet., 

Ext. opii aquosum aa gr. xv. 

Potass, iodid 3 iv. 

Potassas acetat 3 ij. 

Aquae dist fl. 3 iijss. 

Vini alb fl. % iv. 

M. S. — Twenty drops three times a day. 



HEMORRHAGE. 

Dr. A. L. Ranney gives the following rules 
for meeting all possible indications in the treat- 
ment of hemorrhage : 1, always ligate the 
bleeding vessel Id moderate hemorrhage, when 
convenient to do so ; 2, use compression over 
the wound on the main trunk in moderate hem- 
orrhage, when ligature of the wounded artery 
is inconvenient ; 3, in violent hemorrhage en- 
large the wound and tie the artery ; 4, as a rule, 
never attempt ligation except when bleeding 
actually exists. The exceptions to this rule 



142 pkescbiber's memokanda. 

are : #, in exposed vessels of large calibre de- 
manding ligature as a safety measure ; 5, in 
delirium tremens, following an injury ; c, when 
necessity for transportation exists ; 5, ligation 
should, as a rule, be applied at the bleeding- 
point, and not remote from it ; 6, use the ex- 
ternal wound as a guide to your incision to 
reach the vessel, except when the wound exists 
on the side opposite to the vessel injured, when 
a probe may be cut down upon ; 7, always use 
the greatest precaution to avoid needless loss of 
blood in reaching the vessel until the fingers 
can compress it; 8, the artery, when found, 
should be tied above and below the wounded 
portion, and at a bifurcation three ligatures 
should be used. In case the lower end cannot 
be discovered, use compression in the wound 
as a substitute for ligature ; 9, a ligature should 
not be placed close below a large branch ; 10, 
in recurring hemorrhages the treatment should 
depend on the color of the blood and on the 
severity of the hemorrhages. If the hemorrhage 
springs from the proximal end of the artery : a, 
tie if possible ; 5, amputate if necessary ; c, use 
styptics and compression, if both are impossible ; 
11, amputation is preferable to ligature: a, when 
great swelling of the limb renders ligation diffi- 
cult ; &, when exhaustion of the patient forbids 



pkescriber's memoranda. 143 

further search for the vessel ; c, when compe- 
tent assistance is needed and not attainable ; 
12, in case a large vessel is injured without 
actual hemorrhage, hot flannels to the limb are 
indicated as a preventive measure ; 13, in case 
an aneurism is the seat of the hemorrhage — 
provided the aneurism is traumatic in its origin 
— it should be treated on the same principles 
as if it were a wounded artery. 



Pecholier's favorite prescription in haemopty- 
sis is as follows : 

^. Ipecacuanhae contus 3 jss. 

Aquas bulliente fl. 5 iv. 

Make an infusion; filter; add syr. acaciae, 
fl. § j. Give a tablespoonful every hour or two. 

The first dose may cause vomiting ; but this 
soon ceases, and indeed, may be prevented by 
the addition of a few drops of laudanum. The 
absorption of the emetic being thus rendered 
easier, pulmonary anaemia is rapidly and surely 
produced. 

]£ . Acid, sulph. arom T^xl. 

Ext. hematoxyli 3 j. 

Tinct. opii camph fl. 3 iv. 

Syr. zingiber q. s. ad. fl. § j. 

M. Dose, two teaspoonfuls in haemoptysis. 



144: prescriber's memoranda. 

Vesical Hemorrliage. 

u If instruments are really necessary to with- 
draw blood and urine, then the slow injection 
of iced water, or, better still, of iced infusion of 
matico, may be useful. Even a mild solution 
of the tincture of the perchloride of iron, as a 
cold injection, I have known in one case to suc- 
ceed when all others have failed ( 3 j. t. ferri, 
| iv. aquse). 

' ; Keep the patient on his back, and forbid 
straining as far as possible in passing water. 
To this end give opium liberally to subdue the 
painful and continued action of the bladder. 
Apply cold by means of bags of ice to the peri- 
neum and above the pubes. Better still, intro- 
duce small pieces of ice into the rectum. Do 
not use an instrument if it is possible to do 
without it. There is a great dread in some 
people's minds about the existence of a large 
coagulum in the bladder. Leave it alone ; it 
will gradually be dissolved and got rid of by the 
continued action of the urine." 

Sir Henry Thompson. 



Dr. Prout observes: u When the bladder be- 
comes distended with blood, and complete re- 
tention of urine in consequence takes place, 
recourse must be had to a large -eyed catheter 



pkescklbek's memoranda. 145 

and an exhausting syringe, by the aid of which 
and the occasional injection of cold water, the 
coagula may be broken up and removed. If 
the hemorrhage be so profuse that the bladder 
becomes again distended with blood in a very 
short time, the injection of cold water into the 
rectum or bladder is sometimes of great use ; 
and should these means fail, from twenty to 
forty grains of alum may be dissolved in each 
pint of water injected into the bladder, a rem- 
edy that seldom fails to check the bleeding, 
even when the cause is malignant disease." 



In urethral hemorrhage ergot has acted well. 
Give fifteen-drop doses of the fluid extract every 
fifteen minutes. Boyland. 



Br. W. A. Gordon commends very highly 
the use of tincture of hydrastis Canadensis in 
uterine hemorrhage, menorrhagia, and dysmen- 
orrhcea. He says : 

"The tincture I use is prepared after the fol- 
lowing formula : 

I£. E,ad. hydras. Can. (fresh). ... 3 ij. 
Aquas dist Oj. 

" Maintain at a temperature of 120° F. for 
twenty-lour hours; then add spts. rect., Oj., 
remove from the bath, and in three days it is 
10 



146 pbesceibeb's memobanda. 

ready for use. In those urgent cases where I 
formerly resorted to half -drachm and drachm 
doses of the fluid extract of ergot every twenty 
or thirty minutes, I now use the tincture of hy- 
drastis in doses of from twenty to thirty drops, 
repeated the same as ergot, until the active 
hemorrhage is controlled. The remedy is then 
continued in small doses — say two to five drops 
every two to four hours, according to the 
urgency of the symptoms." 

In dysmenorrhoea he combines it with bro- 
mine, with good results. 

Nervous patients should not be given over ten 
drops of the following solution : 

3£ . Bromini gtt. j. 

Aquse dist Oj. 

Large doses continued for several weeks pro- 
duces membranous dysmenorrhoea. 



Dr. Penrose, in a paper ' ' on vinegar as a rem- 
edy in the treatment of post-partum hemor- 
rhage," claimed the following advantages : 

1. It could be easily obtained. 

2. It could be easily applied, and instantly, 
without special apparatus. 

3. It always cured the hemorrhage, at least 
it had not failed in his practice. 

4. It was sufficiently irritating to excite the 



prescrd3er's MEMORANDA. 14:7 

most sluggish uterus to contraction, and yet not 
so irritating as to be subsequently injurious. 

5. It was an admirable antiseptic. 

6. It acted on the lining membrane of the 
uterus as an astringent. 

The remedy was applied as follows : saturate 
a rag with vinegar, carry it into the cavity of 
the uterus, and squeeze it. 

In the vast majority of cases the hemorrhage 
ceased as if by magic, when the vinegar passed 
over the surface of the uterus and vagina. It 
could be easily repeated if the first application 
failed. 



Nitrite of amyl in post-partum hemorrhage 
has been used with most satisfactory results by 
Dr. Elias W. Kern. The patient was in collapse 
when the nitrite was given by inhalation. The 
hemorrhage ceased at once and permanently, 
and the patient was restored. 



Solutions of Ergotine for Hypodermic 
Injection — (These Besnard). 

1. Ergotine, 2 grammes (3ss.); water, 15 
grammes ; glycerine, 2 grammes (Hildebrandt). 

2. Ergotine, 2 grammes ; water, 15 grammes; 
glycerine, 15 grammes (Moutard-Martin) ; 1 
gramme of this solution contains 0.666 millig. of 
ergotine, and is equivalent to 0.50 of ergotine. 



148 pkescriber's memoranda. 

3. Ergotine, 2 grammes ; water, 30 grammes 
(Bucquoy). 

4. Yvon's extract of ergot, 1 gramme, 20; 
water, 8 grammes, 80 (Dujardin Beaumets). A 
strong solution double the strength of the pre- 
ceding. 

Yvon's extract is recommended for its un- 
alterability, and because each gramme corre- 
sponds to one gramme of ergot. 



]£ . Ergotini gr. xxxvj. 

Glyceringe, 

Aquae aa Tf^ cviij. 

M. Ergo tin solution for hypodermic use. 



Dr. Porak cites three cases of obstinate nasal 
hemorrhage, each of which was promptly ar- 
rested by a single hypodermic of ergotin. His 
formula was : Bonjean's ergotin, two grammes; 
glycerine, thirty grammes. M. Twenty drops 
hyp oder mically in the lip or cheek. 



HAIR, Falling of. 

Hoffmann's Balsamic Mixture is composed of 
the oils of lavender, cloves, cassia, thyme, lemon, 
mace, and neroli, of each four parts ; balsam of 
Peru, twelve parts, and alcohol, 1,000 parts. It 
is also called Hoffmann) ] s Balsam of Life. 



peesceibeb's memoeanda. 149 

^ . Hoffmann's balsamic mixture. 25 parts. 

Glycerine 25 parts. 

Rose-water 100 parts. 

Tinct. cantharid , . . . 4 parts. 

Carbonate of ammonia 5 parts. 

M. Shake well and filter after one hour. 
Rub in well once a day for a hair tonic. 

3 • Cologne Oj. 

Tinct. sang 3 ij. 

Glycerinse § ij. 

Tinct. canth § ss. 

Castile soap (grated fine) § ss. 

M. Apply once a day with a brush, to pre- 
vent the hair from falling. 

^. Ung. petrolei, 

Olei ricini aa § ss. 

Hyd. ox. rub gr. v. 

Liq. ammon. fort fl. 3 ss. 

Olei rosmarini gtt. v. 

M. For falling of the hair in cases where it 
occurs without obvious cause. J. Startin. 

^ . Baras sulphid 3 jss. 

Zinci oxid 3 vj. 

Mix with water to form a paste ; apply for 
three minutes and wash off. A depilatory. 

McCall Anderson. 



150 prescriber's memoranda. 

~fy . Sodse sulphid gr. xlv. 

Calcis caust., 

Pulv. amyli aa 3 ijss. 

Make into a paste with a little water, and 
apply for one or two minutes. A depilatory. 

BOUDET. 



1£. Liq. amnion, fort., 

01 ei amygdal., 

Chloroformi aa, 3 ijss. 

Spts. rosmarini § ss. 

Olei limonis ess q. s. 

M. For falling of the hair. Wilson. 

3 . Sodae salicyl 3 ss. 

Acid carbol 3 ss. 

TJng. simplex § j. 

M. For alopecia areata. 



HEADACHE. 

As to the treatment of headache. Dr. Day ad- 
vises, as a preliminary step, a diligent search 
after the cause of the disorder, which, when 
found, should be removed as speedily as possi- 
ble. The remedies to be used are tonic or cal- 
mative, as the case may require. If the brain 



prescriber's memoranda. 151 

be over- excited, bromides of potassium and 
ammonium, chloral hydrate, and morphia as a 
hypodermic injection or in other form, may be 
used. The morphia, combined with an infini- 
tesimal dose of atropia, and used with care, has 
been found to be an invaluable remedy, even in 
cases of organic disease. In nervous headaches, 
a stimulating emetic of sulphate of zinc, mus- 
tard, or ipecacuanha, will act like magic, as will 
also a mustard-leaf at the back of the neck, the 
feet and legs being at the same time put into 
hot water. In the neuralgic variety tonics are 
serviceable, especially cod-liver oil, phosphorus, 
quinine, and arsenic. The local application of 
aconitina ointment is serviceable in that form 
known as brow-ague. As a general treatment, 
it is recommended to elevate the head at night, 
and to make use of a hard pillow. In every 
case, the first principle to inculcate is rest. 



Dr. "Weir Mitchell, relating a case of migraine 
occurring in a girl seven years and a half old, 
exhibiting the congestive type, and for which 
he prescribed small doses of bromide, gr. iij., 
and tinct. belladonnas, gtt. iij., observes that 
the use of the old domestic remedy — a tight 
bandage — during the attack, is useful. He em- 
ploys a rubber bandage, applied thoroughly 



152 prescreber's memoranda. 

from the eyes up, with a thin pad over each 
temporal artery, if the temporal ridge be sharp 
enough to keep the bandage from squeezing the 
arteries, and over the two occipital vessels. 
Instead of caoutchouc, a well-applied muslin 
bandage may be put on, and then wetted, using 
compresses over the temporal arteries. The 
comfort thus given is sometimes surprising. 



Br. Seguin, in the treatment of migraine, 
eliminates all psychic stimuli so far as is possi- 
ble. He also orders alkalies, and in anaemic 
cases iron and cod-liver oil, while he prohibits 
the use of carbohydrates and flour. During 
the attack he recommends rest, with depriva- 
tion of light and food. In cases in which the 
attack is anticipated, he relieves it by the ad- 
ministration of the fluid extract of Paullinia 
sorbilis — two teaspoonfuls in the course of one 
to two hours, or the powder of the same plant, 
twenty to thirty grains every half -hour ; caff ein, 
two grains hourly, repeated three or four times, 
or croton- chloral, fifteen to twenty grains re- 
peated about four times, are also useful. Sub- 
cutaneous injections of morphia or atropine are 
disapproved of, although they may occasionally 
be of use. The treatment in the intervals be- 
tween the attacks consists in the administra- 



prescriber's memoranda. 153 

tion of alcoholic extract of cannabis Indica to 
the extent of one-third of a grain daily before 
each meal. This dose may be increased after 
some weeks to one-half grain, and, in men, to 
two-thirds of a grain. The pills are to be taken 
on an average for about three months. The 
author places the means here mentioned, in re- 
lation to their action in migraine, upon the 
same footing as potassium bromide in epilepsy. 



HEART DISEASE. 

Dr. T. Grainger Stewart finds that improve- 
ment follows the use of cardiac tonics, particu- 
larly iron, in disease of the heart characterized 
by pallor, restlessness, headache, slight dropsy, 
and breathlessness. Dilatation and partial fail- 
ure of the heart's action are usually found with 
these symptoms. He gives the tincture of per- 
chloride of iron, sometimes to the amount of 
twenty minims every two hours, more frequently 
every four hours, continuing its use for days to- 
gether. In many cases improvement follows very 
speedily. To obviate the gastric derangement 
so often following upon the use of iron, he com- 
bines the chloride of ammonium with it, half a 
grain to each minim of the tincture. The com- 
bination renders the administration of iron pos- 



154 prescriber's memoranda. 

sible in patients who otherwise can scarcely 
use it ; indeed, in no other way can iron be ad- 
ministered in sufficient quantities to afford re- 
lief, and in many instances to save life. 



1$. Tinct. ferri perchlor 3 ij. 

Syr. zingiber 3 vj. 

Infus. digitalis § v. 

M. Tablespoonful three times daily, for car- 
diac weakness, with dilatation of the ventricles. 



In the weak heart of elderly persons, Dr. 
Fothergill combines digitalis with chloroform : 

If. Tinct. digitalis \ x. 

Spts. chlorof ormi 71^ xx. 

Infus. buchu § j. 

M. For one dose. 

In conditions of debility, where it has to be 
taken continuously for months or years at a 
time, he recommends it in pill-form, combined 
with iron and bitters, as : 

If. Pulv. digitalis 3 j. 

Ferri sulph. exsic Sij. 

Strychnise gr. ij. 

Pulv. pip. nig 3 ij. 

Ext. gent. 3 ij. 

M. For sixty pills. One or two twice daily, 
after meals. 



prescriber's memoranda. 155 

1$. Fl. ext. cactus grandiflor .... 3 j. 
S. — Capiat TT^ iij. to x., p. r. n., for palpita- 
tion of the heart. 



HERNIA. 

Dr. F. H. Hamilton, on posture and traction 
in the treatment of strangulated and incarcer- 
ated hernia, gives the following conclusions : 

1. Hernial apertures are not under the con- 
trol of the muscles. 

2. Posture does not relax the aperture when 
the seat of the hernia is in the sac itself, nor 
when it is at the internal ring in inguinal hernia. 

3. Neither warmth nor cold, nor any other 
sort of local applications are capable of relaxing 
the apertures. 

4. Neither do chloroform nor other anass- 
thetics affect hernia apertures, except, perhaps, 
in cases where the hernia is very recent. 

5. In short, hernia apertures can seldom be 
affected at all by any means brought to bear 
upon them, whether local or general ; but this 
is not requisite for relief, since the strangulation 
is not the result of contraction of these aper- 
tures, but of the pressure of the distended her- 
nia upon them. 

In regard to the postural treatment, he says : 
1. Taxis is of prime importance. 



156 pkesckibee's memoranda. 

2. Internal traction is only second to this in 
value. It is to be effected by securing- paralysis 
of the abdominal muscles and exciting peri- 
stalsis in the intestines. 

3. Chloroform, hot baths, and other similar 
agents, are the best means for accomplishing 
muscular relaxation, peristalsis, and antiperis- 
talsis. 

4. Ice can only relieve the t{ buttonholing," 
when this is due to congestion, and when it is 
applied very early. Opium is of a somewhat 
limited application. 

5. Emetics may be of service by causing an 
upheaval of the viscera, and also, probably, by 
exciting peristalsis. 

6. Purgatives act by causing peristalsis and 
antiperistalsis below the seat of stricture. 

7. Stimulating enemata and enemata of to- 
bacco also induce peristalsis, and are both direct 
and indirect in their effects. 

8. All positions of the patient are beneficial 
in which the viscera are drawn upward; and 
that is likely to be of most service which causes 
the most efficient inward traction, at the same 
time that it does not interfere with the trial of 
taxis. 

Dr. Post attaches great importance to inward 
traction, and relates a case in which it was sue- 



prescriber's memoranda. 157 

cessful after Dr. Kearney Rodgers had decided 
upon herniotomy. The following is the method 
by which inward traction was effected : a stout 
man was directed to raise the patient's hips up- 
on his back, by carrying his knees across his 
shoulders, when in a few minutes the hernial 
tumor disappeared. 

This method was practised successfully for 
many years by Dr. Holt, of New Orleans, when 
he was living in Wilkinson County, Miss. He 
styled it the inversion of the patient. While the 
patient was thus inverted an assistant was en- 
gaged in making traction upon the abdomen. 



HERPES. 

M. A. Fournier recommends, in cases of her- 
pes zoster, that the ulcerated vesicles should be 
washed with a solution of hypochloride of soda 
diluted with half its volume of water, and the 
wound then covered with cotton-wool impreg- 
nated with a powder composed of subnitrate of 
bismuth, four parts, and calomel and oxide of 
zinc, of each one part. Should the eruption be 
extensive, absolute repose is recommended, to- 
gether with bran or starch baths ; and, inter- 
nally, opium and bromide of potassium. 



158 prescriber's memoranda. 

Cover the part thoroughly with collodion in 
herpes zoster. The relief is usually prompt and 
permanent. 



HICCOUGH. 

Dr. Ortille was successful, with gr. - 3 L 6 - of mu- 
riate of pilocarpine, in curing hiccough which 
had resisted every remedy. 



Spray the epigastrium for ten minutes with 
sulphuric ether, then the site of the phrenic in 
the neck. Repeat twice a day, if necessary. 

Regoni. 



HYDROPHOBIA. 

Hypodermic injections of curare, one grain 
every half -hour until spasms cease, and contin- 
ued pro re nata, have effected cures in several 
cases. 

^ « Curare gr. x. 

Aquas TTL c. 

M. Bartholow. 



prescriber's memoranda. 159 

INEBRIETY. 

Ij, . Tinct. capsici ' gtt. x. 

Tinct. nucis vom gtt. x. 

Acid, nitric, dil gtt. xx. 

Aquae § j. 

M. S. — Take as a draught in water three or 
four times a day to remove the nausea, depres- 
sion, and craving for drink. 



INSOMNIA. 

3 . Chloral hydrate 3 iij. 

Potass, bromid 3 iv. 

Tinct. opii 3 j. 

Syr. aurant. cort | ss. 

Aquas ad. § iij. 

M. S. — Take 3 j. To be repeated, if neces- 
sarv. Kane. 



INSANITY. 

Dr. George H. Savage, of the Bethlehem 
Asylum, gives the results of his experience in 
the treatment of insanity, more especially in 
the use of drugs. Early removal from home he 
considers the first step in almost all cases. He 



160 pbescbibeb's memoranda. 

finds few cases of sthenic insanity. Stimulants 
should therefore be used instead of depressants. 
Food well selected and administered is at the 
basis of treatment. He thinks well of the 
shower-bath in cases due to self-abuse, and of 
the wet pack, especially in the mania of hys- 
tero-epilepsy. He uses no form of opium but 
morphine. Melancholies seem to do well under 
its use, but the cure takes so long that time 
may be the curative agent after all. It is most 
beneficial in climacteric and senile cases, and 
most hurtful in mania. He thinks chloral has, 
all things considered, done as much harm as 
good. He finds it useful in epileptic mania, in 
cases due to excess of alcohol, and in puerperal 
cases. In wildly maniacal and erotic patients 
he gives it in from ten- to thirty-grain doses 
rubbed up with an equal quantity of camphor 
in syrup. He found alarming symptoms to fol- 
low, however, in one case, after twenty grains 
of the mixture had been taken, 

Succus conii and hyoscyamine he uses spar- 
ingly in noisy and destructive cases. He has 
almost discarded bromide of potassium, except, 
presumably, for epilepsy. Prefers saline pur- 
gatives to all others, and Hunyadi Janos to all 
other waters. Next to quiet and absence from 
home, stimulants take rank. He finds koumiss 



pbesceibee's memoranda. 161 

of use in hysteric dyspepsia and anorexia, in 
doses of a pint daily, as it is easily digested and 
prevents waste. As emmenagogues he uses 
Griffith's mixture and compound decoction of 
aloes or tincture of black hellebore. He thinks 
amenorrhoea is seldom a cause of insanity in 
otherwise healthy subjects. It is often due to 
the same cause as its accompanying depression. 
He uses the above remedies if the menses do 
not reappear after the general health has been 
restored by iron or other tonic treatment. 
Finds physostigma of some use in the conges- 
tive stage of general paralysis, inducing remis- 
sions of the prominent symptoms. Does not 
have a high opinion of electricity, though he 
has used it rather too seldom to speak with 
authority. Has noticed recoveries after the 
occurrence of some local inflammation so often 
as to suggest the propriety of more common 
use of counter-irritation. In gouty cases, cure 
the gout, and you may cure the insanity. Gen- 
erally speaking, treat causes and conditions. 
Moral treatment must, however, he thinks, be 
for a long time, and perhaps forever, the chief 
aim. With correct management from the start, 
nearly all cases of insanity unattended by pa- 
ralysis or physical decay, may be cured. 
11 



162 prescriber's memoranda. 

INTERTRIGO OF INFANTS. 

Wortheimber says : When the stools are thin 
and of acid smell, he employs two or three times 
daily the following powder : 

$ . Calcis precipitat gr. jss. 

Bismuth, subnitrat gr. j. 

Sacchari albi gr. iij. 

M. 

In other cases, where the discharges have a 
less serous character and are characterized 
rather by abundant yellowish white flakes of 
caseine, minute doses of muriatic acid produce 
better results. The fact, however, still remains, 
that many cases will be found rebellious to 
every treatment, and recovery will be effected 
only by the employment of a wet-nurse. Great 
care must be taken to remove wet diapers, and 
to insure the underclothing's being always dry. 
It is better in washing the folds of the skin — 
the favorite seat of intertrigo — to use lukewarm 
soap and water, as this removes more easily 
than cold water the accumulated fatty secre- 
tions. 

Powders should be used locally only when the 
epidermis is sound ; otherwise they are injuri- 
ous by adhering to the secretions and forming 
crusts j which act as foreign bodies and increase 



, prescriber's memoranda. 163 

irritation. The sporules of the lycopodium, ow- 
ing to their oily nature, are preferable to the 
different amylaceous powders. Still better is 
an admixture of semen lycopodii with finely 
powdered subnitrate of bismuth or oxide of 
zinc. 

Whenever the intertrigo is so advanced as to 
present moist excoriations, a different treatment 
should be immediately adopted. The author 
strongly disapproves of the use of the so-called 
"drying salves" prepared with animal fats, 
such as zinc and lead ointments, and attributes 
the severity of many cases that have come 
under his care to the injurious effects of their 
long and lavish use. A decided preference is 
expressed for the unguentum diachyli of Hebra, 
and its employment in fresh cases is generally 
satisfactory. In other cases it fails, and the 
author has of late employed, in severe forms of 
the disease, a remedy that has completely ful- 
filled every expectation, namely, corrosive sub- 
limate. 

His method of using this latter remedy is 
very simple. The solution employed is : 

I£. Hydrarg. chlor. corrosiv 0.05 

Aquse dist 100 

M. About one grain to four ounces of water. 



164 prescriber's memoranda. 

Pieces of lint are soaked in this solution and 
laid upon the diseased surface. It often suffices 
to apply the solution in this manner three or 
four times a day for an hour at a time, and it 
is rare that the application must be continuous. 



IODOFORM. 

The very unpleasant pungent odor of iodo- 
form can be almost completely masked by oil of 
peppermint. For instance, iodoform 3 ss. , vase- 
line §ij., rubbed up with six drops of oil of 
peppermint, makes an ointment with a pleasant, 
aromatic scent. 



Shake tincture of iodine with a fragment of 
fused potassa till the color be removed. Cover 
the odor of the iodoform thus produced by the 
addition of eau de- Cologne. Dip lint in this 
solution, allow it to dry, and one has an excel- 
lent application for indolent ulcers, anal fissures, 
burns, etc. 



ITCHING (Pruritus). 

1$. Prepared chalk 10 parts. 

Coal tar 1 to 4 parts 

Glycerine 5 parts. 

Simple cerate 50 parts. 



pkesckiber's memoranda. 165 

Or the following : 

1>. Prepared chalk 8 parts. 

Coal tar 1 to 2 parts. 

Linseed oil 20 parts. 

Shave off the hairs, or cut them very short ; 
then apply this ointment once or twice a week. 
For barber's itch. 

1. Ablution with tepid water to be substi- 
tuted for paper after defecation. 2. Suppos. 
ext. bellad., gr. ss. , every night. 3. Bowels 
regulated with a mild laxative, as acid tartrate 
of potash with confection of senna. 4. Mixture 
containing small doses of quinine and arsenic, 
two or three times a day. 

Glycerinum acid, carbolic, at bedtime every 
night, and the following to be applied every 
morning : 

1$. Hydrarg. chlorid. mit 3 j. 

Camphor 3 ss. 

Vaseline 3 vjss. 

M. 

Iy. Acid, carbolic „ . . . . 3 j. 

Olei olivae § j. 

Apply with the finger at bedtime. 
Glycerite of tannin, or a mixture of equal 
parts of compound tincture of benzoin and wa- 



166 prescriber's memoranda. 

ter. The best application is strong mercurial 
ointment at bedtime, or — 

I£. Ungt. hydrarg. fort 3 j. 

Chloroform 3 j. 

Adipis benzoat 3 j. 

Acid, carbolic gr. xv. 

M. S. — Use every night. 

1$. Schule's hydrocyanic acid .... 1TL xxx. 

Liq. morph. sulph 3 j. 

Tobac. opt 3 j. 

Aquas q . s. ad. 3 ss. 

To be used night and morning. For Pruritus 
Ani. 

1$. Balsam of Peru § j. 

Benzoic acid gr. ex. 

Oil of cloves gtt. xl. 

Alcohol 3 ijss. 

Simple cerate § vij. 

Dissolve the essential oil and the benzoic acid 
in the alcohol, and mix them with the cerate. 
Lastly, add the balsam of Peru. It is said to 
effect a cure in twenty-four hours. For scabies. 
Dr. Andrew J. B. Jenner, of Detroit, writes : 
"Experience has taughfc me that men of a 
nervous-bilious temperament frequently suffer 



prescriber's memoranda. 167 

from itching of the scrotum — and women of the 
same temperament, from itching of the puden- 
da. There is no eruption in either case. 
Scratching the parts, however, produces such 
an exquisitely voluptuous sensation, and so in- 
tensifies the itching, that continued scratching 
frequently abrades and excoriates the parts. 
Such pruritus is not a disease of itself, but 
merely a symptom of hyperesthesia of the local 
cutaneous nerves, caused by the permeation of 
uric acid or bile. Such cases are invariably re- 
lieved by the internal use of the tincture of 
aconite. In severe cases the same remedy may 
be applied externally. The following prescrip- 
tion will, in most cases, suffice : 

1$. Tinct. aconiti rad 3 j- 

Ex. aquae 3 xij. 

u Cujus cochleare unum magnum ter quaterve 
in die summendum." 

Dr. Auerbach has for some time treated 
pruritus by the application of balsam of Peru, 
and with the greatest success. After the first 
rubbing into the part great relief is obtained. 
Cure results in a few days. 

M. Marius Key recommends the glycerole of 
cade as a local application in the treatment of 
pruritus of the vulva. The formula he employs 



168 peesceibek's memokanda. 

is one drachm of oil of cade to half an ounce 
of glycerole of starch. In combination with it 
he uses tonics, hip-baths, and emollient injec- 
tions, to which laudanum is freely added. He 
has tried this treatment only once in a really 
rebellious case, but that time with success. 

Wear a piece of cotton-wool, of the size of a 
walnut or larger, at the anus ; a few shreds of 
the wool should be inserted inside the sphincter, 
and this will be sufficient to retain the whole in 
its place. A fresh piece must be used after 
evacuation. Pruritus ani. 

Dr. John Pirnat says that with the following 
treatment for itch he cured, in one week, be- 
tween eighty and ninety students in 1862, and 
it has never failed in his hands since : 

1$. Calc. ox § vj. 

Aquas O v. 

M. Let stand for half an hour, then add : 

1^. Zinci sulph § j. 

Sulph. sub „ J iij. 

M. Put it in an iron vessel and let it boil 
for half an hour, stirring continuously ; then 
allow it to cool. Pour the liquid into a bottle, 
and label " Liq. Sulphuris Comp." 

Let the patient be well washed, then rub 
thoroughly with this solution the whole body 
every night before going to bed, for three sue- 



prescriber's memoranda. 169 

cessive nights, without changing the clothes ; at 
the same time let the patient take every morn- 
ing a dose of mag. sulph., or the following : 

ly, Potassaa tart 3 ijss. 

Sulph. sub § vj. 

Rhei pulv % j. 

Sacchari alb 3 ss. 

M. S. — Two teaspoonfuls in a glassful of 
water three times daily, till the bowels are 
freely opened, then once or twice a day. 

On the third day the patient should wash 
thoroughly with warm water and castile soap, 
then dress in clean clothes, when the cure is 
complete. 

To conceal the smell of the above preparation, 
oil of cloves, roses, or bergamot, may be used. 

IJ. Iodini gr. xij. 

Potass iodid gr. vjss. 

Alcohol I j. 

Aquas § v. 

M. For itching of the scrotum. 

I> . Hydrarg. bichlorid gr. vj . 

Spts. rosmarini, 

Alcohol aa 3 j. 

Mist, amygdal. arnar 3 vj. 

M. Pruritus. Wilson. 



170 prescriber's memoranda. 

^ . Camphoras, 

Chloral hydrate aa 3 j. 

Ung. aquae rosse § j. 

M. Pruritus. Bulkley. 



LAXATIVE BREAD. 

Mr. W. H. Taylor says that he has bread pre- 
pared as follows, and finds it most useful in 
constipation and as a laxative in piles : coarse 
Scotch oatmeal, whole wheaten flour, coarse 
ordinary flour, of each equal parts. The bread 
can be lightened by yeast, or, to a two-pound 
loaf, one tablespoonf ul of baking-powder, made 
of four ounces of bicarbonate of soda, three 
ounces of tartaric acid, one pound of ordinary 
flour, rubbed well together, and kept dry in a 
tin or well -corked bottle. The bread keeps 
well, and a two-pound loaf will be sufficient for 
a week, baking a portion once or twice a day in 
conjunction with ordinary bread. 



LAXATIVE AND PURGATIVE MIX- 
TURES. 

^. Pil. hydrarg., 

Resin, scammonii, 

Pulv. aloes aa gr. xx. 

Olei carui q. s. 

M. Divide into 20 pills. 



prescriber's memoranda. 171 

* l Rags" Pills. 
Yf,. Pulv. rhei, 
Pulv. aloes, 
Pulv. gentianse, 

Pulv. saponis aa gr. xx. 

M. Divide into 20 pills, 

Segur*8 Pills. 

Yy, . Pulv. aloes gr. lx. 

Ext. colocynth. co gr. xxx. 

Ext. hyoscy ami gr. xxx. 

Ext. nucis vom gr. xv. 

M. Divide into 60 pills. 

Squibtfs Laxative Pills. 

Ifr . Resinse podophylli gr. xxxvj. 

Ext. bellad. alcoh gr. xviij. 

[or] Ext. hyoscy am. ale, 

Pulv. capsici, 
^ Pulv. sacch. lactis aa gr. cxliv. 

Pulv. acaciae gr. xxxvj. 

Glycerinse TTJ_ xl. 

Syrupi q. s. 

M. Divide into 144 pills. Dry them by ex- 
posure to the ordinary temperature, until just 
hard enough to retain their form. Then put 
them into a well-stoppered bottle. 



172 prescriber's memoranda. 

I£. Ext. colocynth. co gr. xxxvj. 

Resin, podophylli gr. ix. 

Resin, leptandrae gr. iij. 

Pulv. jalapae. gr. vj. 

Pulv. aloes Soc gr. xij. 

Ext. hyoscyam gr. vj . 

Olei menthse pip gtt. v. 

M. Divide into 24 pills. 



Walker's Pills. 
$. Ext. nucis vom., 

Ext. belladonna aa gr. v. 

Ferri sulph. exsic, 

Ext. aloes aa gr. x. 

M. Divide into 20 pills. 



A pleasant method of administering castor- 
oil consists, says Dr. Starke, in mixing the oil 
with coarse granular sugar until a thick paste is 
formed. This usually requires about one part 
of oil to three of sugar. The addition of a 
small amount of cinnamon-powder suffices to 
give the mass a pleasant taste. The writer 
finds this candy uniformly successful in children, 
who will rebel against the oil in any other form. 
The bulk is so great that this mode of adminis- 
tration is almost necessarily confined to chil- 



prescriber's memoranda. 173 

dren's practice. For adults, the addition of 
compound liquorice-powder, in the proportion 
of one part to two of oil, will form a bolus 
which can be readily swallowed. 



Rub two drops of the oil of cinnamon in an 
ounce of glycerine, and add an ounce of castor- 
oil, to render the oil palatable. 



M. Yvon finds that the disagreeable taste of 
sulphate of magnesia may be completely con- 
cealed by the addition of a few drops of the 
essence of mint, provided that the quantity of 
the vehicle be small. He advises that 5 vj. of 
the sulphate should be dissolved in about § j. 
of water, two or three drops of the essence of 
mint being then added ; or the flavoring agent 
may be added "to the salt, and the patient di- 
rected to dissolve the whole in as small a quan- 
tity of water as possible. 



r) . Ferri sulphatis g-r. ij. 

Magnesii sulphatis 3 ij. 

Aquas fl. 3 j. 

M. Dose, a tablespoonf ul , in constipation of 
anaemia. 



174 peesckibek's memoranda. 

^ . Pulv. sennse 2 parts. 

Pulv. glycyrrh. rad 2 parts. 

Pulv. f oeniculi 1 part. 

Sulphuris loti 1 part. 

Pulv. sacchari 6 parts. 

M. Dose, 30 to 60 grains. 



LEAD-POISONING. 

Milk as an Antidote to Lead- Poisoning. — A 
singular fact is given of the effect of the habit- 
ual use of milk in white-lead works. In some 
French lead-mills it was observed that, in a 
large working population, two men who drank 
much milk daily were not affected by the lead. 
On the general use of milk throughout the works, 
the occurrence of lead-colic ceased. Each oper- 
ator was given enough extra pay to buy a quart 
of milk a day. From 1868 to 1871 no cases of 
colic had appeared. 



LUPUS. 

Dr. H. G. Piffard reports several cases of lupus 
treated by excision, scraping, or actual cautery, 
or by a continuation of these means. Thorough 



prescriber's memoranda. 175 

and radical treatment is insisted upon; every 
lupus-cell must be destroyed. We must seek 
to replace the lesion by a cicatrix, to prevent a 
relapse in situ aud the development of the dis- 
ease elsewhere. This is best done by excising 
or scraping away the lupus-tissue, and then em- 
ploying- the galvanic or other actual cautery. 
Internal remedies are of value only as benefit- 
ing the general health of the patient. Scraping, 
followed by the actual cautery, is the least pain- 
ful of the radical operations proposed, and cica- 
trization is most rapid, the resulting scar being 
smooth and less disfiguring than that following 
spontaneous involution or the potential caustics. 
Success depends upon the thoroughness in op- 
erating. Relapses in situ occur usually in three 
months; elsewhere they may appear later. 
Here constitutional treatment is very necessary. 



5 • Iodini, 

Potass, iodid aa 3 ss. 

Glycerines 3 j. 

M. Lupus. McCall Anderson. 



Tubercular Lupus of the Face. 

1. Cover the parts invaded by the tubercles 
with an ointment made as follows : 



176 prescriber's memoranda. 

I£ . Bromide of mercury 3 jss. 

Axungia 3 v. 

2. Cod-liver oil, two tablespoonfuls night and 
morning. 

3. Take, morning and evening, before meals, 
a tablespoonf ul of the following solution : 

1$, . Distilled water 5 viijss. 

Chloride of sodium 3 iv. 

Iodide of potassium 3 1£- 

Considerable amelioration took place in two 
months. Hardy. 



MALARIA. 

From experiments conducted at Bellevue Hos- 
pital, Dr. Gaspar Griswold found that pilocarpine 
administered hypodermically will cut short the 
chill of intermittent fever. It also, in a large 
number of cases, aborted the paroxysm, that 
is, by inducing a profuse sweat, prevented any 
hot stage following. The dose is one-fifth of a 
grain of the muriate. 



Dr. Fordyce Grinnell says that, while he was 
occupying the position of Government physician 
at the Wichita Indian Agency, he treated 135 
cases of intermittent fever with ten-drop doses 



pbescriber's memoranda. 177 

of tincture of iodine in a third of a glass of 
sweetened water, three times a day, with the 
most beneficial results. He says : " The remedy 
seemed to act almost as if by magic ; in many 
instances the paroxysms were not repeated after 
the medicine was given." 



Dr. P. Filatow has used the infusion of sun- 
flower. The infusion is prepared by cutting the 
stem of the sunflower (fresh or dry) into small 
pieces, and macerating it for three or four days 
with common cognac, when it acquires the color 
of sherry and the distinctive taste of the drug. 
The dose is a tablespoonful three times a day. 



Dr. Masoti gives his experience in the use of 
carbolic acid. The patient had suffered with 
intermittent fever for ten months, and was 
treated by a quack with all kinds of bitters and 
by bleeding. Then quinine was freely taken, 
with an infusion of tobacco, without success. 
Carbolic acid, one- tenth of a grain, was then 
given, and in three days the fever commenced 
lessening in intensity, and at the ninth day dis- 
appeared. The carbolic acid was mixed with 
strong coffee, made very sweet. The next case 
of intermittent fever had been of five months' 
standing, and was similarly treated successfully. 
12 



178 peesceibeb's memoranda. 

Haberkorn has very successfully used the 
ethereal oil of mustard, on account of its anti- 
bacterial properties, in the pernicious fevers of 
malaria. He gives two or three drops a day in 
a great quantity of distilled water ; or better, 
from two to four drops in a ten per cent, alcohol 
solution. His results have been ' ' most remark- 
able. " 



Surgeon W. E. Saunders speaks of the suc- 
cessful use of nitrite of amyl in the cure of 
ague, where he gave it in two-drop doses by in- 
halation, combined with the oil of coriander in 
equal quantities. He regards it as a powerful 
diaphoretic, and uses it in all cases of fever to 
produce diaphoresis. 



Dr. L. Austin Porter says : a I have been using 
sulphite of soda in many of the malarial fevers. 
I find the results quite satisfactory, not a grain 
of quinine being necessary. It has appeared 
to me that cases thus treated are less subject to 
a relapse ; the career of the fever is cut percep- 
tibly short, and convalescence immediately be- 
gins. I take the tongue of the patient as my 
guide- board for the administration of this salt. 
When I find ifc presenting a broad, flabby appear- 
ance, with pale texture, and covered either with 



prescriber's memoranda. 179 

a pasty white, yellow, or brownish coat, with 
bad taste in mouth and fulness of stomach, 
sulphite of soda is my remedy; and with these 
signs I regard it as a very valuable remedy. 
But if the condition of the tongue be different 
from that here described, it will do more harm 
than good. It is absurd to administer it to a 
patient whose tongue is red, red-edged with 
fur in centre, or even covered with fur entire, 
while the body of it is red, or in which red 
papillse are projecting up above the coating. 
There is nothing that will clean off the tongue 
quicker than this salt. 

• ' My mode of giving this remedy is to use 
about sixty grains, divided into ten powders- 
one powder given every two hours in mucilage, 
albumen, or slippery -elm tea.' 7 



Where Anaemia is a Prominent Symptom in 
Malaria. 

Vf, . Ferri et potassas tart gr. v. 

Liq. potass, arsenitis TT^ ij. 

Potass, bicarb gr. x. 

Tinct. nucis vom 71^ v. 

Aqua? ad. 3 j • 

To be taken in a wineglassful of water, before 
eating. J. 0. Webster. 



180 pbescriber's memoranda. 

Tonic in Malarial CacJiexia. 

fy . Quinias sulph gr. ij. 

Acid . arsenios gr. -j- -. 

Pulv. capsici gr. j. 

Ext. taraxaci q. s. 

To be taken before each meal. 



MENSTRUAL DISORDERS (See Dysmen- 
orrhea and Hemorrhage). 
Dr. J. R. Black gives bromide of ammonium 
in too frequent menstruation, in ten-grain doses 
before each meal and at bedtime, in those cases 
of menstruation occurring in women from pu- 
berty to their thirtieth year, in whom the in- 
terval is about two weeks and the irregularity is 
not due to displacements, inflammation, nor de- 
generations, but seems to be due to over-excite- 
ment of the genital organs. 



For irregular menstruation, when associated 
with and dependent on ansemia, neuralgia, and 
neurasthenia, the following may be used : 

3^ . Tinct. f erri mur 3 x. 

Liq. potassge arsenitis 3 ij. 

M. Sig. — Twelve drops after each meal, 
through a glass tube, in about one-third glass of 
water. 



pbescbiber's memoranda. 181 

For Delayed Menstruation : 

#. Apiol , 3ij. 

Liq. potass, arsenitis 3 j. 

Tinct. ferri chlor 3 ij. 

Syrupi 3 iij. 

M. S. — Teaspoonful, t. i. d., before meals, 
for one week, and alternate with simple chaly- 
beate treatment. 



MILK, Suppression of. 
MM. Boucher and Fonssagrives have estab- 
lished the efficaciousness of the ricinus communis 
for increasing or re-establishing the secretion of 
milk. It is used thus : a handful of the leaves 
of the ricinus communis are boiled in a litre of 
water. The breasts are bathed with the decoc- 
tion for fifteen or twenty minutes ; there is then 
applied to the nipples a poultice made with a 
part of the same leaves, which is left on till 
they become dry. The result is obtained after a 
few hours ; but, if the secretion is very tardy, 
fumigation of the genital organs with the boiled 
leaves may be added. 



MOLES. 

Dr. Thomas writes: U I strongly advise the 
acid nitrate of mercury in removing moles 
from the face. The acid should be applied with 



182 peesceibee's memoeanda. 

a splinter of wood, and gently rubbed on the 
part for several seconds, according to the thick- 
ness of the growth. Great care should be taken 
to prevent the acid from reaching the surround- 
ing skin. There is absolutely no pain attending 
the application, and the growth gradually shriv- 
els away, and the slough falls off in about a 
week. 



NBTTLERASH. 

I£ . Atropia sulphat gr. i. 

Aqua3 dist. s 

(xlycerinas , aa 3 ss. 

Pulv. tragacanth q. s. 

M. Ft. pil. no. x. S. — A pill morning and 



Dr. G-uibout remarks that in ordinary cases 
of urticaria the treatment is very simple ; but, 
when it becomes chronic aud dependent upon 
permanent dyspeptic derangements, medical 
agents are required. In this case we may have to 
resort to emetics, purgatives, or stimuli, etc., of 
which he prefers strychnia. 



Dr. Q. C. Smith says : First give a full emetic 
dose of ipecac, and after it has acted thorough- 
ly* gi ve fl» ex k of belladonna, in small doses, 



pkesceiber's memoranda. 183 

every two hours, until its characteristic flush of 
the skin is produced on the face, or until vision 
is considerably disturbed. This degree of im- 
pression should be maintained, gradually dim- 
inishing the dose for two or three days. Such 
constitutional treatment as may be indicated in 
each case should be duly instituted, though 
many cases require nothing further than the 
belladonna. 



NEURALGIA. 

In neuralgia of the fifth pair, Prof. Fereol, 
of Lyons, believes he can report good results 
from the following : 

I£. Cupri ammonio-sulphat gr. j.-iv. 

Syr. florum aurant fl. 3 j. 

Aquae dist fl. 3 iij. 

One-third as a dose, three times a day. 
It gives a fetid odor to the breath, which 
should be disregarded. 



Dr. B. M. Griffith recommends the following 
for trifacial neuralgia : 

I£ . Croton chloral 3 ij. 

Syr. aurant § ss. 

Simple elixir § ijss. 

M. S. — Half tablespoonful in water, once in 
two hours, until paroxysm is relieved. Chloral 



184 peesckibek's memoranda. 

hydrate will not do. This potion to be increased 
or diminished according- to age, condition, etc., 
of patient. Follow, after quieting pain, with : 

I£ . Quinise sulph 3 j. 

Tinct. gelsemium 3 jss. 

Simple elixir 3 iij. 

M. S. — Teaspoonful once in two hours, un- 
til six portions-have been taken each day. 



Duquesnel's aconitia has been used with 
marked success in some cases of facial neural- 
gia. Commence with T \-$ gr. , and gradually in- 
c ease to -g^, or until pricking and tingling are 
manifested or the pain is alleviated. 



Professor Massini, of Basle, recounts his ex- 
perience of the use of gelsemium in the treat- 
ment of eighty cases of neuralgia of the trige- 
minus. In cases of this sort Dr. Massini gives 
twenty minims of the tincture every half-hour 
up to three doses, and he finds that the first dose 
usually affords relief, and that the pain rapidly 
subsides after a second or third dose has been 
taken. He has never found it necessary to ex- 
ceed sixty minims, and only in one case did this 
quantity produce unpleasant head-symptoms. 
The cases in which the remedy produces most 



prescriber's memoranda. 185 

benefit are those of simple rheumatic neuralgia 
of the alveolar branches of the trigeminus ; in 
those it rarely fails. It also sometimes relieves 
the pain remaining* after the stopping of a 
carious tooth. Where there is any inflammatory 
affection of the bone or periosteum, no good 
can be expected from the remedy. The medi- 
cine may, if necessary, be repeated several days 
in succession, the active principle rapidly pass- 
ing off by the kidneys. 



Marino publishes the results of his experiments 
with ergot: 1, in tic-douloureux, local injec- 
tions of ergot give better results than any other 
remedies, quinine included ; 2, the results are 
equally good in hemicrania ; 3, in some cases of 
sciatica, very good results have been obtained, 
while in other cases no relief has been afforded 
to the patient ; 4, ergot should be administered 
in other cases of neuralgia, especially if the lat- 
ter is caused by blood-poisoning or cachexia ; 
5, the injection itself is often painful, but ab- 
scesses do not often supervene ; the pain gen- 
erally ceases in half an hour, especially if a 
cold compress has been immediately applied to 
the place. The neuralgic symptoms, as a rule, 
disappear after one or two injections ; but it is 
advisable to continue them for some time ; 6, the 



186 pkescribeb's memoranda. 

dose for one injection varies from fifteen centi- 
grammes (two grains) to two decigrammes (three 
grains) of ergot dissolved in water or glycerine. 



M. Mauriac treats the neuralgia symptomatic 
of syphilis with iodoform pills, according to the 
following formula : 

I?. Iodoform powder gr. xx. 

Ext. and powder of gentian. . q. s. 

Divide into twenty pills, two or three to be 
taken daily. 



^ . Aconitias gr. iv. 

Veratrias gr. xv. 

Glycerine 3 ij. 

Cerati 3 vj . 

M, S. — To be rubbed over the parts. Care 
should be taken to see that there is no abrasion 
of the skin. Da Costa. 



Among the many local applications in neural- 
gia, Prof. Da Costa has found this one the best 
adapted for general use : 

$ . Yeratriaa 3ij. 

Adipis I j. 

M. et ft. ungt. For external use. 



prescriber's memoranda. 187 

^ . Tinct. aconiti rad fl. 3 ij. 

Chloroformi fl. 3 j. 

Tinct. iodinii co fl. 3 ij. 

M. Apply with a brush. 



James Mason recommends : 
I£ . Chloroformi pur. , 

Tinct. aconiti (F lemming's) aa 3 iij. 

Tinct. capsici 3 j. 

Tinct. pyrethri, 

Olei caryoph., 

Pulv. camp aa 3 ss. 

M. 

As a local anaesthetic while extracting" teeth, 
and to relieve toothache. The tooth and sur- 
rounding gum are dried, four or five drops of 
the mixture applied, and the tooth extracted 
without pain by warmed forceps. To relieve 
toothache, fill the cavity of the tooth with a 
pellet of cotton soaked in the mixture. 



I£ . Ext. belladonnas gr. x. 

Ext. stramonii 3 ss. 

Acid, tannic gr. viij. 

Adipis q. s. ad. § j 

M. et ft. ungb. For external use. 



188 prescriber's memoranda. 

P. Squire's Formula for " Chlorodyne" 
1^. Chloroformi purif fl. J iv. 

iEtheris fort fl. 5 j. 

Alcoholis fort fl. 5 iv. 

Syr. fusci fl. § iv. 

Extr. glycyrrh. pulv ? ijss. 

Morphias hydrochlorat gr. viij. 

Olei menthae piper 7T[ xvj. 

Acid, hydrocyan. dil. (2#) fl. § ij. 

Syrupi fl. § xvijss 

Dissolve the morphia and oil of peppermint 
in the alcohol ; mix the chloroform and ether 
with this solution. Mix the liquorice with the 
syrup and add the molasses. Shake these two 
mixtures well together ; lastly add the hydro- 
cyanic acid, and again shake well. Dose, 5 to 10 
minims or 10 to 20 drops. Always shake the 
mixture before using. 

1$. Morph. mur gr. ss. 

Chloral hyd., 

Chloroform aa 3 ss. 

Tinct. cannab. Ind., 
Tinct. capsici, 

Acid, hydroycan. dil aa TT\_ xx. 

Spts. menth. pip TT^ x. 

Syr. sassafras co ad. | j. 

Dose, |j. 



prescreber's memoranda. 189 

This I have named Elixir Chloroformi Com- 
positus, and can heartily recommend it to those 
who have been in the habit of using ehlorodyne. 

McNutt. 



3 . Quinias sulph. , 

Ferri pyrophosph aa 3 3. 

Strychnia3 gr. j. 

Acid, phosph. dil. (tribas) .... fl. 3 ij. 

Syr. zingiber fl. § ij; 

Aqua? q. s. ad. fl. 5 iv. 

M. Dose, a tablespoonful. 



NiEVUS. 

Sodium ethylate, used since 1871 by Br. J. 
Brunton, is prepared by adding the metal sodium, 
piece by piece, to absolute alcohol in a wide- 
mouthed bottle ; when effervescence ceases, a 
crystalline substance, C2 H5 NaO, has been de- 
posited at the bottom of the flask. Dr. Rich- 
ardson has the credit of bringing this and other 
alcoholic and ethylic derivatives into notice in 
1870. He says : ki When it is brought into con- 
tact with water it is decomposed ; the sodium 
becomes oxidized by the oxygen of the water, 
forming sodium hydrate, the hydrogen of the 



190 pkescriber's memokanda. 

water going" to reconstitute the common or ethy- 
lic alcohol. The change of ethylic alcohol into 
sodium transforms it from an irritant to a caus- 
tic. Laid on dry parts of the body, the sodium 
ethylate is comparatively inert ; but, as soon as 
the part to which the substance is applied gives 
up a little water, the transformation described 
above occurs, caustic soda is produced in con- 
tact with the skin in proportion as water is 
eliminated, and there proceeds a gradual de- 
struction of tissues, which may be moderated so 
as hardly to be perceptible, or may be so inten- 
sified as to act almost like a cutting instrument." 
It is, therefore, valuable for the destruction and 
removal of malignant growths beyond the reach 
of the knife, by application to the surface or by 
subcutaneous injection into the growths. Upon 
the unbroken skin only slight pain is caused, 
quickly checked by the addition of chloroform. 
These alcohols dissolve opium — also suggest- 
ing to Dr. Richardson the possibility of a 
sure, rapid, and painless caustic. Caustic alco- 
hols may be used in combination with local an- 
aesthesia from cold. Thus, with ether-spray 
and the subcutaneous injection of caustic alco- 
hol, we have a valuable means for treating a 
poisoned wound, such as a snake's or a mad 
dog's bite. So possibly for cystic tumors. Po- 



pkesckcbee's memoranda. 191 

tassium and sodium alcohol dissolved in the 
volatile hydride of amyl produces a caustic so- 
lution ; applied to the skin, the hydride evapo- 
rates, the caustic remains. Compared with the 
action of nitric acid, there is less destruction of 
epidermis and less paiu, and hardly any scar- 
ring, the action of the ethylate being limited to 
the spot where it is applied. 



B. W. Richardson says that the ethylates are 
sometimes called alcohols, because in them the 
atom of hydrogen, which in alcohol is, with its 
radical, combined with oxygen, is replaced by 
an atom of sodium or potassium. He treated, 
in 1870, a small nsevus, on the neck of a child 
two years old, with sodium ethylate. This 
nasvus was cured by six applications of the 
fluid, and a sound surface left. Soon afterward 
another, as large as a half-dollar, and quite 
prominent, was treated in the same manner. 
The application gave very little pain. The nsevus 
soon turned dark. In three days a firm, harl 
incrustation had formed. A few days later 
this was dry enough to be lifted off. The naavus 
had been reduced in size. Sodium ethylate was 
again applied as at first, and so on till the nasvus 
was removed and a natural surface left. Time 
required, nine weeks and three days. 



192 prescriber's memoranda. 

NIGHT-SWEATS. 

Dr. Murrell, in a series of interesting and 
instructive papers, reviews the various agents 
known to check night-sweating. Oxide of 
zinc has long proved trustworthy in doses 
ranging from two to ten grains at bed-time. 
Sulphate of atropia, Eolith to Tooth grain, in- 
jected hypodermically, has lately proved most 
valuable, a single dose often checking the sweats 
for many days. It is often noticed that the 
first night shows no good effects, but, on the 
second night, without any fresh injection, the 
sweats disappear, to return slightly the next 
night, and, on the fifth night, they will be as bad 
as ever, but will then be speedily arrested by 
another dose. Gallic acid, quinine, and iron, all 
play an useful role in the treatment of indi- 
vidual cases. In nitrite of amyl, administered 
in minim doses, we have a recent valuable addi- 
tion to our remedies. In seventeen test-cases 
it relieved fourteen ; it has not, however, yet 
proved so prompt as atropia in its action. 
Water, applied locally, as hot as can well be 
borne — indeed, a few degrees hotter — often re- 
lieves local sweating. Sage tea has at times 
proved valuable. In Dover's powder we have a 
most valuable therapeutic agent in doses of five 



pkesckiber's memoranda. 193 

grains once or twice in the night ; and, while it 
is inferior to atropia, it is far more reliable 
than oxide of zinc. Picrotoxine, the alkaloid of 
cocculns Indicus, has yielded excellent results. 



Dr. William Murrell gave pilocarpine, the 
alkaloid of jaborandi, in seventeen cases of con- 
sumption night-sweats, in all of which it did 
some good, and in most cases was a great suc- 
cess. G-ive it in pill — one -twentieth of a grain 
at bedtime only, or three or four times in the 
day. 



Night -sweating of phthisis and other diseases 
is treated in the Hospital of the University of 
Pennsylvania, with small doses (-^-j to -£& gr.) of 
atropia combined with small doses of jaborandi, 
which does away with the occasionally un- 
pleasant effects of the atropia. 



Dr. Q. C. Smith recommends, as very efficient 
in the night-sweats of phthisis : 

^ . Zinci oxid gr. j. 

Acid pyrogallici gr. ij. 

Atropiae sulph gr. T ^. 

M. S. — For one pill. Dose, j.-ij., thrice daily. 

13 



194 prescriber's memoranda. 

For Night-sweats of Consumptives : 

I£ . Acid salicyl 1 part. 

Amyli 3 parts. 

Talci , 29 parts. 

M. Ft. pulv. 

The whole body is to be powdered every night. 
If the skin should be too dry, lard, alcohol, and 
tannin is rubbed in to make the powder adhere. 
To prevent the burdensome cough produced by 
the salicylic acid, the mouth and nose are cov- 
ered with a cloth. Kohnhorn. 



NIPPLES, Fissure of. 

I£ . Plumbi nitrat gr. x-xx. 

Glycerinse § j. 

M. S. — Rub on the sore nipples. 

Fordyce Barker. 

^ . Aquse rosse § iijss. 

Liq. plumb, subacetat. dil . . . . § ss. 

Ext. opii aq 3 j. 

Sig. — Use as a lotion, wetting linen in this 
and covering the breast with two thicknesses of 
it, having previously applied a bread and milk 
poultice to the breast. 

This is recommended by Dr. Barker in in- 
flamed nipples. 



pkescriber's memobanda. 195 

Dr. M. O'Hara has found the following appli- 
cation to fissured nipples very satisfactory, giving 
prompt relief to pain : 

I£ . Iodoformi 3 ss. 

Collodion § j. 

M. S. — Paint on the part from time to time. 



Dr. Buttler says : When fissures of the nipples 
are not due to some constitutional cause, tinc- 
ture of benzoin freely applied to the parts will, in 
about five to ten days, effect a cure. Only the 
first application is painful. Tincture of benzoin 
forms a covering on the surface of the nipple, 
and so protects it from the child. Lactation is 
never interrupted by this process of treatment. 



^ . Iodoform 3 ij. 

Balsam Peru. . § j. 

M. S. — For external use. 



ORCHITIS (See also Epididymitis). 
Dr. Z. C. McElroy gives the following plan of 
management of this painful disease. It consists 
in hypodermic injection of morphias sulph., in 



196 PRESCRIBES MEMORANDA. 

£ gr. doses, into the cellular tissue of the scro- 
tum, and internally : 

3 . Calomel gr. iij. 

Ipecac pulv gr. x. 

M. S. — Take at once. 

Administer a saline cathartic in the morning 
and follow with smaller doses of calomel and 
ipecac every six hours. Repeat hypodermics of 
morphise, p. r. n. Apply locally : 

$ . Hydrarg. ammoniat 3 j. 

Cerati simp § j. 

M. Ft. ungt. S. — Apply as directed. 



A saline cathartic and belladonna extract, 
made soft and smeared over the scrotum, has 
given good results. 



ONYCHIA MALIGNA. 

Dr. Gaetano was called to a little girl ten 
years of age, who had suffered severely for six 
months with peri- and sub-ungual ulceration of 
the right index finger. Having softened and 
raised up the nail as much as possible, he 
dropped a concentrated solution of morphia 
upon the sore, with which he kept it in contact 
a quarter of an hour. He then covered the 



prescriber's memoranda. 197 

diseased part with very finely powdered nitrate 
of lead and enveloped the finger with a bandage. 
The pain was almost immediately relieved, and 
the patient slept soundly that night for the first 
time in a long period. Cure in five days. 



PARALYSIS, Spinal. 

Dr. Wm. T. Plant recommends the following in 
spinal paralysis of infants : If the initiatory 
fever is high, aconite in minute and frequent 
doses will be in place, with tepid bathing. And 
as in other cases, where a child is feverish, ap- 
parent causes of irritation should be relieved. 
If the gums are swollen by coming teeth ; if 
constipation is present ; if there are evidences 
of worms in the bowels ; if there is any want 
of activity in the digestive processes, you will 
know what to do. 

As soon as attention is drawn to the spine by 
the discovery of paralysis, your thoughts will 
naturally turn to those agents whose physio- 
logical effect is to diminish the blood- supply of 
the cord. 

Chief among those at present known are ergot 
and ergotine, and less certainly, belladonna and 
potassium bromide and iodide. Possibly the 
hyperaemia of the cord may be lessened by ru- 



198 peescbibee's memobanda. 

befacients to the spine. Tincture of iodine con- 
siderably diluted is a good agent for this pur- 
pose. The following is a good rubefacient lo- 
tion : 

]$. Spts. rectificat., 
Acid, acetici, 
Tinct. capsici equal parts. 

M. S. — Wet a cotton cloth with it and lay 
along the spine. 

The application of leeches may also be of 
service. 

After a little time — two to three weeks — if 
the palsied muscles are not steadily regaining 
their power, resort should be had to those agents 
that stimulate muscular contractility. Chief 
among these are strychnia and electricity. Of 
the former, I would commence with a small 
dose, not exceeding the fiftieth of a grain to a 
child of two years. Remember that half a 
grain has killed a grown person. The quantity 
may be increased gradually and guardedly. 

In electricity we have a most valuable means 
of restoring lost power to muscles. 



PATENT MEDICINES. 

Walker's California Vegetable Vinegar Bit- 
ters. — Each bottle contains from nineteen to 
twenty fluid ounces, consisting of a decoction of 



presceiber's memoranda. 199 

aloes and a little gum guaiac, anise seed and 
sassafras bark, in water slightly acidulated with 
acetic acid, possibly the result of secondary fer- 
mentation, or added in the form of sour cider. 
Each bottle contains also about one ounce of 
Glauber's salt, oiie-fourfch of an ounce of gum 
arabic, and from one-half to one ounce of alco- 
hol. (Eberbach, Hoffmann, Nichols.) 



BrandretJV s Pills. — Each box contains twenty- 
four or twenty-five pills, weighing about two 
and one -half grains. The twenty-four pills con- 
sist of ten grains of podophyllum root, ten grains 
of extract of the same, thirty grains of the ex- 
tract of poke-berries, ten grains of powdered 
cloves, from two to five grains of gamboge, 
traces of Spanish saffron, and a few drops of 
oil of peppermint. (Hager.) 



Radway's Ready Relief. — This is a light brown 
liquid, consisting of three parts of soap lini- 
ment, one part of the tincture of capsicum, one 
part of aqua ammonia, and one part of alcohol. 
(Hager, Heckolt, Hoffmann.) 

Radway's Renovating Resolvent. — Each bottle 
contains about six fluid ounces of a vinous tinc- 
ture of cardamom and ginger, sweetened with 
sugar. (Hager. ) 



200 pkescribee's memoranda. 

Pierced Golden Medical Discovery. — Each bot- 
tle contains one drachm of the extract of let- 
tuce, one ounce of honey, one-half drachm of 
the tincture of opium, three ounces of dilute 
alcohol, and three ounces of water. (Hager.) 



Pierce's Favorite Prescription. — A greenish 
brown, turbid liquid, consisting of a solution of 
one-half ounce of sugar, one drachm of gum 
arabic, in eight ounces of a decoction made 
from two drachms of savine, two drachms of 
white agaric, one and one -fourth drachm of 
cinnamon, and two drachms of cinchona bark ; 
to this mixture are added one-half drachm of 
tincture of opium, one-half drachm of tincture 
of digitalis, and a solution of eight drops of oil 
of anise in one and one -half ounce of alcohol. 
(Hager.) 

Van Buskirk's Fragrant Sozodont. — A red 
liquid, consisting of a solution of one-half drachm 
of white castile soap in one ounce of alcohol, 
three-fourths of an ounce of water, and one- 
fourth of an ounce of glycerine, colored with 
cochineal, and flavored with oils of wintergreen, 
cloves, and peppermint. The powder which ac- 
companies each bottle consists of a mixture of 
precipitated chalk, powdered orris-root, and car- 
bonate of magnesia. — (Wittstein, Hoffmann.) 



prescriber's memoranda. 201 

Ayer's Cherry Pectoral : 

^ . Morph. acetat gr. iij. 

Tinct. sanguin. Canaden 3 ij. 

Vini antim. et potas. tart. , 

Vini ipecac aa 3 iij. 

Syr. pruni Virgin § iij. 

M. 

Hamlin's Wizard Oil: 

^. Spts. camph § j. 

Spts. ammon., 

Oil sassafras aa § ss. 

Oil cloves 3 ij. 

Chloroform, 

Oil turpentine aa § ss. 

Alcohol ad. § v. 

M. 

Perry Davis* Pain Killer : 

^ . Spts. camph | ij. 

Tinct. capsici 5 3- 

Gum guaiac J ss. 

Alcohol § iij. 

Tinct. myrrh to color. 
M. 

Hamburg tea, so popular as a domestic reme- 
dy, is composed as follows : senna leaves, eight 



202 pbescbibeb's memobanda. 

parts ; manna, four parts ; coriander, one part. 
Mix. 



PHARYNGITIS. 

In chronic pharyngitis apply a solution of 
nitrate of silver, thirty grains to the ounce. 

I£ . Tinct. guiaci ammoniat 3 v. 

Tinct. aconit rad. , 

Tinct. belladonnae aa 3 ss. 

Syr. lemon § ss. 

A quae cinnamomi ad. § iv. 

M. S. — Take 3 j. every three hours, for acute 
pharyngitis. 

^ . Tinct. aconit. rad gtt. xv. 

Acid, hydrocyan. dil gtt. xx. 

Liq. ammon. acetat § ij. 

M. S. — Teaspoonful every two or three 
hours, according to the severity of the case. 
Acute and subacute pharyngitis. 



I£ . Zinci sulph 3 ij. 

Potass, chlorat § j. 

Morph. sulph gr. ij. 

M. et div. in chart, no. xij. S. — Dissolve 
one in a tumbler of water, and use for a gargle. 

R. R. Lincoln. 



prescbiber's memoranda. 203 

In chronic pharyngitis, where the blood-ves- 
sels of the pharynx are enlarged and tortuous, 
and the secretions moderate, Mr. Dabney reports 
excellent results from the following : 

^ . Ergotine gr. xx. 

Tinct. iodini fl. 3 j. 

Glycerines fl. 5 j- 

M. S. — Apply to the pharynx freely twice 
daily with a camePs-hair brash. 

If. Hyd. bichlor gr. vj. 

Acid, hydrochlor gtt. xij. 

Syr. simp § j. 

Aquae dist ad. § viij. 

M. S. — Use several times a day, as a gargle 
in syphilitic sore throat. 

I£ . Acid, acetic, dil TT[_ xv. 

Glycerinae 1P C xviij. 

Aquas I j. 

M. S. — Use for a stimulant gargle. 

^ . Acid, hydrochlor 7T[_ xij. 

Glycerinae fT^ xxiv. 

Aquae I j. 

M. S. — Use for a stimulant gargie. 



204 prescriber's memoranda. 

Potass, bromid gr. x. to ^ j. 

S. — Use for an antiseptic gargle. 

B Potass, chlorat gr. xij to § j. 

Potass, permang gr. vj . to § ij . 

Acid, carbolic gr. ij. to § j. 

M. S. — Use for an antiseptic gargle . 

Ij, . Acid, tannic gr. xij. 

Alcohol TT[ vj. 

Aquse camphor § j. 

M. S. — Use for an astringent gargle. 

I£ . Ahiminis gr. viij . to § j. 

Boracis gr. xxiv. 

Glycerinse Tf^ xxiv. 

Tinct. myrrhse Tf|_ xxiv. 

Aqua3 1 j. 

M. S. — Use for an astringent gargle. 

^ . Krameria inf us § ss. 

Aquae Oj. 

M. S. — Use for an astringent gargle. 



prescriber's memoranda. 205 

Strength of Solutions for Spraying : 

3 . Acid, tannic gr. iij . to § i. 

Ferri perchlor gr. iij. to § j. 

Zinci chlorid gr. ij. to § j. 

M. S. — Astringent. 

3 . Acid, hydrocyan 3 j. to J j. 

Potass, bromid 3 j. to % j. 

M. S. — Sedative. 

r) . Acid, tannic gr. x. to 3 j. 

Ferri perchlor gr. v. to 5 j. 

M. S. — Haemostatic. 

1$, . Lime-water J ]• 

Acid, carbolic gr. iij. 

M. S. — Antiseptic. 



PTYALISM. 

3 . Hypophosphifce of soda 3 ij. 

Hypophosphite of lime 3 ij. 

Water 3 iv. 

M. Dose, tablespoonful every four hours. 

Burner. 



206 prescriber's memoranda. 

Stop mercury and use warm baths, and the 
following diuretic : 

fy . Potass, citrat § j. 

Aquse \ iv. 

M. 3 j. four times a day in water. 

Keyes. 



PERINEUM, Laceration of. 
Dr. Goodell advises the immediate operation, 
which he has found to be very successful in in- 
complete lacerations. In complete lacerations 
it is not as successful as the secondary opera- 
tion. In the primary operation, in order to put 
in the stitches accurately, Dr. Goodell recom- 
mends that ether be given, and that a sponge be 
placed high up in the vagina to stop the flow of 
the lochia, which embarrasses the operator. 
The stitches are applied as in the secondary op- 
eration, and merely twisted together. In the 
secondary operation, if the sphincter ani is in- 
volved, he always imbeds the first two stitches. 
On the eighth day all the stitches are removed, 
except the lowest. The faeces are then softened 
by an injection of warm sweet oil, and the 
bowels are moved twelve hours later by an ounce 
dose of castor-oil, aided, if necessary, by an in- 



peesceibee's memoeanda. 207 

jection. After the bowels have been emptied, 
the remaining stitch is removed. 



PILES. 

Dr. F. P. Atkinson says, in the acute stage 
they are inflamed, of a dark red appearance, 
and give rise to a throbbing, burning pain, or 
like that which would be produced by the appli- 
cation of a red-hot coal. Mr. Biddle, a fellow- 
practitioner, tells me that in this stage the effect 
of calomel-dusting is something wonderful, and 
that relief is more quickly gained from this than 
anything with which he is acquainted. He con- 
siders that it acts in a twofold manner, viz.: 
upon the liver and at the same time as a local 
sedative. Sponging also with hot water gives 
marked relief. If this treatment prove ineffi- 
cient, and the pain be very excessive, leeches 
may be applied to the anus, or an incision made 
into the centre of the swelling and the contents 
squeezed out. 

In the subacute stage the feeling complained 
of is more that of weight and tension, though 
on going to stool the pain is often very acute. 
To relieve the existing condition, the compound 
gall ointment, or a solution of acetate of lead 
and opium, should be freely and frequently 



208 peesceibee's memoeanda. 

applied, and an enema of cold water used after 
each action of the bowels. 

In the chronic stage the best application is the 
common pitch ointment. For this useful piece 
of knowledge I am indebted to a Mr. Corbett, 
and he, it appears, got the hint from an old 
nurse by seeing her apply some tarred rope. Its 
astringent effect is something remarkable, and 
I know of nothing which acts so quickly and 
effectually. 

The general treatment has to be directed 
toward altering the particular mode of living 
which has brought about the abnormal condition. 



Lansing says he has found ergotine supposi- 
tories, used night and morning, efficacious in 
bleeding piles. 



$ . Pulv. opii gr. xx. 

Liq. plumb, acet 3 ij. 

Vaseline 1 j. 

M. For painful hemorrhoids. 



Dr. Cuffer extols the anaesthetic action of 
iodoform in fissura ani and haemorrhoids. 

A ten per cent, solution in ether may be used 
with an atomizer. 



pkesckiber's memokanda. 209 

^ . Iodof ormi 3 ]'• 

Acid, carbo. 

Acid, tannic aa gr. xv. 

Ext. belladonnas, 

Pulv. opii aa gr. viij . 

Vaseline § j. 

M. Ft. ungt. Geo. Ross. 



Dr. Edmund Andrews has recently made a 
laborious inquiry into the results of over three 
thousand three hundred cases treated by hypo- 
dermic injection of carbolic acid, reported to 
him by about three hundred physicians. From 
a study of these cases he deduces the belief 
that, if the following rules be observed, the 
method of treatment by hypodermic injection 
will be less painful than any other, and equally 
safe : 

1. Inject only internal piles. 

2. Use diluted forms of the remedy at first, 
and stronger ones only when these fail. 

3. Treat one pile at a time, and allow from 
four to ten days between the operations. 

4. Inject from one to six drops, having smeared 
the membranes with cosmoline to guard against: 
dripping. Inject very slowly and keep the pipe 

14 



210 prescriber's memoranda. 

in place a few moments to allow the fluid to 
become fixed in the tissues. 

5. Confine the patient to bed the first day, 
and also subsequently if any severe symptoms 
appear. Prohibit any but very moderate exer- 
cise during the treatment. 

The operation is to be performed in the fol- 
lowing way : The pile is exposed to view, and 
the anus smeared with an ointment to prevent 
smarting in case the fluid should chance to 
drop. The operator then takes a sharp-pointed 
hypodermic syringe, charged with the carbolized 
liquid (which has been used in varying strength 
from one part of the crystallized carbolic acid to 
thirty of olive oil or glycerine, up to equal parts), 
and slowly throws a few drops into one of the 
piles. The pipe is left in the puncture a few 
moments to prevent the fluid from running out, 
and to allow it to become fixed in the tissue. 

The pile turns white, and in the most success- 
ful cases withers away without pain, suppura- 
tion, or sloughing. Only one pile is treated at 
a time, and about a week is allowed between 
the sessions, until all are cured. Most of the 
cases thus operated upon suffer a sharp tem- 
porary smarting, and a few have a terrible and 
prolonged agony. The majority are cured, how- 
ever, without interrupting the patient's business. 



peesceibee's memoranda. 211 

5 . Extract of belladonna 3 ij. 

Iodoform 3 j. 

Acetate of lead 3 ss. 

Cosmoline § j. 

M. S. — Apply three or four times daily. 
The above will be found a most excellent 
application for painful or inflamed piles. The 
tumors should be bathed in cold water just 
before each application, and the bowels kept 
freely open with a gentle purgative. 



$ . Bismuth, subnit. , 

Tannin aa 3 ss. 

Ext. bell 3ij. 

TJngt. stramon § jss. 

M. Ft. ungt. 

Use fuller's earth in addition, as a local appli- 
cation. C. H. Avery. 



PLEURISY. 

Dr. J. Lewis Smith speaks of the treatment 
of this disease in children as follows : In the 
beginning of the disease measures should be 
adopted which are appropriate for reducing in- 
flammation and limiting exudation. The ab- 



212 pbescribek's memoranda. 

straction of blood in idiopathic pleurisy may be 
beneficial, if judiciously employed, but only one 
or two or three leeches should be employed in 
a robust child, two, three, or four years old. As 
a rule, the loss of blood is injurious in all cases 
of secondary pleurisy, such as follows scarlet 
fever, etc., and also if the quantity of effusion 
is great. Emollient and simply irritating poul- 
tic3s are serviceable in the first stage, and he 
recommends a mixture of one part of mustard 
to sixteen of linseed. It should be made very 
wet, spread thin, applied over the chest in front 
and behind, covered with oil-silk, and changed 
twice in twenty-four hours. For children under 
six or seven months of age, rubbing the chest 
with camphorated oil and applying a simple 
poultice, may be sufficient. 

Blistering at this early stage should not be 
employed, as it increases the inflammation, and 
Dr. Smith has seen a case which terminated 
fatally, in which there was found an increased 
area of inflammation corresponding exactly in 
situation, size, and shape to that of a blister 
that had been applied. 

The indications for the use of internal reme- 
dies in the first stage, are to diminish the fre- 
quency of the pulse, relieve the pain, and allay 
the cou^h. 



pkescriber's memoranda. 213 

To a child tliree years old the tincture of aco- 
nite may be given in doses of half a drop, and 
for a child six years old in doses of one drop 
every three hours, for two or three days. In 
the first stage of primary pleurisy the cardiac 
sedatives may be used. But digitalis is a safer 
and better remedy in all other cases, and it also 
can be used in the second stage. To a child 
two years old the tincture of digitalis may be 
given in doses of one drop every tliree hours, and 
to a child five years old, two drops with the 
same interval. An opiate is ordinarily required, 
Dover's powder, one to three grains, every three 
hours. Hyoscyamus may be used to relieve the 
pain and cough. Digitalis may be combined 
with an opiate ; and morphine and aconite may 
be combined. 

In secondary pleurisy, digitalis is preferable 
to aconite. 

In the second stage, unless the effusion is 
small, measures designed to remove it are re- 
quired. The propriety of using blisters in this 
stage is very doubtful. 

A relaxed condition of the bowels favors ab- 
sorption of serous effusion. Diaphoretics do not 
aid much in the removal of the fluid. Pilocar- 
pine produces a depressing effect which renders 
it unsafe. 



214 presckibek's memoranda. 

Diuretics and tonics are beneficial. Digitalis 
with the acetate of potash is very serviceable. 

^ . Infus. digital § iv. 

Potass, acetat 3 j. 

M. S. — Teaspoonful every three hours to a 
child four or five years old. 

Bitter tonics are especially useful in this stage, 
and the acetate of potash may be combined 
with a decoction of cinchona, with good results. 
A full amount of nutriment should be taken, with 
but little fluid. Of course, the suggestion to 
use a dry diet and diminish the quantity of 
drink, is not applicable to young children. If 
the appetite and the general health are good, 
and there are no symptoms due to the presence 
of the fluid, but little medication is necessary. 
If there are such symptoms and the fluid does 
not disappear, the question of surgical inter- 
ference arises, and the indications for it are the 
following : 

1. Oppressed breathing due to the liquid 
present, whether it be sero-fibrinous, purulent, 
or hemorrhagic. 

2. If there be flat percussion-note over the 
entire affected side, with displacement of the 
heart, even if there be no dyspnoea, for the 
latfcer may occur suddenly. 



pkescribee's memoranda. 215 

3. Moderate effusion without material de- 
crease in quantity by absorption after some 
weeks of treatment. There is danger that 
catarrhal pneumonia, terminating in cheesy 
pneumonia and tuberculosis, may occur in por- 
tions of the compressed lung. Besides, the 
longer the lung is compressed, the more slowly 
will it return to normal expansion after the 
pressure has been removed. 

4. A moderate quantity of fluid coexisting 
with disease of the opposite lung, or of the lung 
of the affected side. 

5. Extension of the inflammation to the peri- 
cardium. Pericarditis, as an extension of the 
inflammation, is not infrequent. 

6. The existence of valvular lesion of the 
heart. 

7. The presence of pus ; empyema. The 
operation of thoracentesis should be performed 
in the eighth intercostal space, on a line perpen- 
dicular with the angle of the scapula. The ad- 
mission of air to the pleural cavity should be 
carefully avoided. The thickness of the thora- 
cic wall is about half an inch — in emaciated 
children it is less. In the introduction of the 
canula, the sharp needle should not be used ; to 
the depth of one inch is sufficient to pass beyond 
the exudation and allow the liquid to flow 



216 peesceibee's memoeanda. 

through the canula. Washing out the pleural 
cavity is unnecessary ; it is injurious rather 
than beneficial, except in cases in which the 
pus is offensive. To empty the pleural cavity 
and approximate the pleural surfaces is the in- 
dication. Dr. Smith thinks there will be a reac- 
tion against the removal of a portion of the ribs 
in cases of empyema. 



Vigier recommends the nitrate of pilocarpine, 
in \ gr. doses, night and morning, to remove the 
fluid in the pleurisy of children. 



Dr. Salvatore Caro preferred an infusion of 
jaborandi — two drachms of the leaves to three 
or four ounces of water and taken at two or 
three doses — to hypodermic injection of pilocar- 
pine, for removing fluid from the pleural cavity. 



^. Potass, acet., 

Infus. digital aa 3 ij.-iv. 

M. S. — This amount each day ; or, 
I£. Pulv. digital., 

Pulv. sillae, 

Hydrarg. chlor. mit aa gr. x. 

M. Ft. pil. no. x. S.— One pill thrice daily. 
Alonzo Clark. 



pbesceibeb's memoranda. 217 

The indications for the treatment of subacute 
pleurisy are to subdue the inflammation and 
promote absorption of the effused fluid. Dr. 
Clark, to accomplish the first of these. effects, 
uses blisters — three being usually sufficient — 
selecting three spots and applying only one 
blister at a time, the second and third not being 
placed in position until the spot of the former 
application has healed. As a diuretic he uses 
potassii iodidi, thirty grains a day ; if this fail to 
diminish the fluid, he has resource to the above 
formulas. If constitutional effects of mercury 
declare themselves, he returns again to the 
potassii iodidi. Dr. Clark uses other means, as 
purgatives, vapor-baths, and mild counter-irri- 
tants when he thinks them indicated, but, 
having exhausted all medical means without 
effect (as is sometimes the case), he either resorts 
to the trocar or does nothing. 



Dr. Hunt has employed jaborandi in cases of 
subacute pleurisy, with success. He gave it in 
as large as half-drachm doses every two hours. 



As a rule, tonics are indicated in subacute 
pleurisy. 



218 prescriber's memoranda. 

PNEUMONIA. 

The Practitioner records four cases of pneu- 
monia which were supposed to have been cut 
short by means of aconite. The drug was given 
in minim doses of the tincture every half- hour 
for four hours, and then in the same dose every 
four hours. The administration was begun on' 
the first day, when there were crepitant rales, 
cough, and rusty expectorations, and seemed to 
have an abortive effect. It is supposed to be 
especially indicated in the first stage of the in- 
flammation. 



In catarrhal pneumonia the following treat- 
ment is pursued in the Hospital of the Univer- 
sity of Pennsylvania : 

To lessen the fever, the two best remedies are 
quinia and digitalis. Salicylic and carbolic acid 
have been tried with the same object in view, 
but have failed. The quinia and digitalis are 
administered as long as the fever lasts, either 
separately or in combination. The usual dose is 
one grain of digitalis and two grains of quinia 
thrice daily. When cough is among the symp- 
toms, opium is given. To stop the distressing 
night- sweats, atropia is used. 

To promote absorption and produce counter- 



prescriber's memoranda. 219 

irritation, blisters are applied to the chest, and 
the following prescription administered : 

I?. Potass, iodid 3 j. 

Ammonii rauriat 3 ij. 

Mist, glycyrrhizae comp. ..... fl. § vj. 

M. S. — A teaspoonful four times a day. 



POLYPI, Nasal. 

The treatment adopted consisted in freely 
puncturing these growths from the anterior 
nares by means of an ordinary acupuncture- 
needle, thus allowing the fluid of which they 
largely consist to drain away. To prevent them 
from refilling, a solution of carbolic acid and 
glycerine, which has a most marked drying-up 
effect, was daily injected into the nostrils for 
some time. In this way many cases were dealt 
with successfully where the growths were of a 
limited nature and the patient averse to their 
evulsion. Reginald Harrison. 



M. Barthelemy treated successfully a case of 
naso-pharyngeal polypus, in a child fourteen 
years old, by the interstitial injection of chloride 
of zinc. 



220 presckibkr's memoranda. 

M. Th. Auger advises a solution of perchlo- 
ride of iron instead of the chloride of zinc. 



Inject five or six drops of acetic acid, by means 
of a hypodermic syringe, into the body of the 
tumor, which will usually shrink up and drop 
off in a few days. 



POULTICES. 

Volkhausen prepares a substitute for linseed- 
meal poultice by saturating a piece of thick, 
white felt-paper with a decoction of linseed. 
This is to be immersed in hot water before it is 
applied, when it swells considerably. It must 
be covered with some impermeable material, 
and fastened securely in place, and ordinarily 
does not require removal before twelve hours 
have elapsed. 



Dr. T. Lauder-Brunton says that the proper 
way to make and apply a poultice is to make a 
flannel bag the required size, fill it with linseed 
poultice made as hot as possible, and place be- 
tween this and the skin a piece of flannel 
doubled ; over the poultice wrap more flannel or 
cotton-batting. 



PRESCRIBES' S MEMORANDA. 221 

PLASTER-OF-PARIS. 

Dr. T. E. Wilcox, Assistant Surgeon, U. S. 
Army, says : A little bicarbonate of soda or 
potassa added to the water in which the hands 
are washed after applying plaster-of-Paris ban- 
dages, etc., immediately removes the unpleasant 
feeling left by the plaster. 



PROLAPSUS ANI. 

Dr. Vidal recommends injection of a solution 
of ergotin. The Paris Medical mentions three 
cases in which this method was employed. In 
one of these the prolapse, which had existed 
for eight years, yielded to the treatment in 
three months. 



PROLAPSUS UTERI. 

A glass speculum is introduced into the va- 
gina, so as to push the uterus into its place. 
Through the speculum a metallic tube or syringe, 
with the end containing about thirty grains of 
tannin, is passed. With a piston the tannin is 
pushed against the uterus, the syringe with- 
drawn, and the packing neatly and effectually 
completed, with a dry probang, around the 



222 prescriber's memoranda. 

mouth and neck of the womb. After the pack- 
ing is completed, the probang is placed against 
the tannin, in order to hold it, and the specu- 
lum is partially withdrawn. The packing is now 
fully secured, and the instrument removed. 

The application of tannin holds the uterus 
firmly and securely in place, not by dilatation of 
the walls of the vagina, but by corrugating and 
contracting its parts. At first the application 
may be made weekly ; finally, but once or twice 
a month. It not only overcomes the hypertro- 
phy and elongation of the cervix, but even, the 
writer thinks, induces a slight atrophy of the 
parts. As a remedy for leucorrhcea, where the 
seat of the inflammation is at the mouth of the 
womb, or within the vagina, it actually gives 
speedy relief. Hochenburgh. 



QUININE, Preparations and Methods of 
Administration. 

^ . Quinise sulph gr. x. 

Pulv. capsici gr. iij. 

Pulv. opii gr. j. 

M. Alonzo Clark. 



Dr. Jaffe, of the Hamburg General Hospital, 
reports very successful results from the hypo- 



prescriber's memoranda. 223 

dermic use of the muriate of quinia and urea 
(made by combining twenty parts of muriate 
of quinia with twelve parts of muriatic acid and 
three parts of urea). The compound is soluble 
in equal parts of water, and such good results 
have been obtained by its use that it should be 
more widely known and used. A fifty per cent, 
solution is recommended ; from five to fifteen 
grains may be injected. The local irritation is 
very slight, at most consisting only of a circum- 
scribed burning pain, without redness or swell- 
ing. Scarcely any subjective sensations have 
been noticed after as large doses as fifteen 
grains. The anti-febrile effects are marked, 
intermittents being cured after the second or 
third injection. 



Milk is recommended as a good solvent of 
quinine, and is said to disguise its bitterness. 
One grain is said by Mr. Batterbury to dissolve 
in an ounce of milk, and render it scarcely bit- 
ter, while two grains do not make it markedly 
bitter. Further, five grains dissolved in two 
ounces do not render it very unpleasant, while, 
put in a tumbler of milk, the bitterness all but 
disappears. Mr. Palmer, of the Birmingham 
General Dispensary, recommends a solution of 
quinine in glycerine — one grain to one drachm. 



224 pbescriber's memoranda . 

A dose of this can be given in a wineglassful of 
milk. Milk would seem to be a good vehicle in 
which to give quinine to children, but with re- 
gard to solubility we cannot understand why so 
few doctors make use of the neutral sulphate of 
quinine, which is soluble in water without the 
addition of acid, and which, therefore, offers 
every facility for administering quinine in a 
liquid form. 



Dr. S. Ashhurst says that if cinchona be 
mixed in the proportion of one grain of alkaloid 
to four grains of sugar of milk and one-tenth 
of a grain of bicarbonate of soda, it will leave 
no bitter taste in the mouth. The mixture may 
be taken dry or dissolved in water. 



Signor Cozzolino recommends the sulpho-thy- 
mate of quinia — a compound of sulphuric and 
thymic { thymol) acid and quinia— as worthy of 
ranking beside the sulphocarbolate or salicylate 
of the same alkaloid. It is freely soluble in 
acidulated water, in ether, and in alcohol. Dose 
is the same as the above-mentioned salts. He 
also calls attention to soda-thymate as a pleasant 
carminative mouth-wash in aphtha and muguet, 
and as an injection in vaginal, uterine, and 
vesical affections. 



presckibek's memoranda. 225 

3. Ferrisulph., 

Quinize sulph., 

Pulv. aloes. aa gr. xx. 

Ext. nucis vom gr. v. 

Exfc. gentian q. s. 

M. Divide into 20 pills. 

^ . Quinias sulph gr. xl. 

Ferri sulph gr. xx. 

Ext. nucis vom gr. v. 

M. Divide into 20 pills. 



Solubility of Quinine Salts. 
Quinine sulphate dissolves in 100 parts of water. 



" bisulphate 


u 


10 


1 ' muriate 


u 


24 " 


1 ' bromide 


u 


50 


" hypophosph. 


a 


60 


4 ' valerianate 


a 


110 u 


" tannate 


a 


500 



Dr. Starke advises that, before swallowing 
powders or pills of quinia, a weak tartaric acid 
lemonade be taken to hasten the action of qui- 
nine. 

15 



226 prescribeb's memoranda. 

Lent's Solution of Quinine, for Hypodermic Use. 
I£ . Quin. disulph gr. 1. 

Acid, sulph. dil 7TL c. 

Aquse font § j. 

Acid, carbolic, liq IT^ v. 

Place the quinine and the water in a porcelain 
dish over a spirit-lamp and heat to the boiling- 
point, then add the sulphuric acid, stirring with 
a wooden spatula. Filter at once into a bottle 
and add the carbolic acid. This solution gives 
gr. vj. to the 3 j. When it gets below 50° F., 
precipitation will occur, and it must be warmed 
before using it. 

RHEUMATISM. 

Dr. H. Gibbons, sr., says that much benefit 
has been derived, in some cases of chronic rheu- 
matism, by wrapping up the knee, or ankle, or 
foot with eucalyptus leaves, renewing them daily 
for a week or more. These leaves are an active 
stimulant to the surface, and will produce vesi- 
cation if their use be long continued. 



A solution of salicylic acid and borax, each, 
gr. x. to fl. § ]'., has a bitter taste and acid reac- 
tion ; whereas a solution of ten grains of the 
former and fifteen of the latter to the ounce 
has no disagreeable taste, is nearly neutral, and 
is just as valuable therapeutically. 



prescriber's memoranda. 227 

$. Sulphur § ij. 

Potass, bitart § j. 

Pulv. rhei 3 ij. 

Guaiaci resiu 3 j, 

Mellis lb. j. 

Pulv. myristica 3 ij- 

M. S. — Take two large teaspoonfuls at night 
and morning for three days, in honey or mulled 
wine. Stille. 



I£. Pulv. resin, guaiaci, 

Potass, iodidi aa gr. x. 

Tinct. colchici sem fl. 3 ss. 

Aquas cinnam., 

Syrupi aa q. s. ad. 5 j- 

M. S. — A dessertspoonful to a tablespoonful, 
thrice daily. Pepper. 



There is a liniment known under the name of 
Russian Spirit, which is used for rheumatism. 
The formula is : 

$. Olei sinapis dist 12 parts. 

Olei terebinth 75 

Camphorae . 75 

Liq. amnion, fort 75 

Tinct. capsici 75 

Alcoholis fort 1,000 



228 peesceibee's memoeanda. 

Treatment of Bheumatic Fever. — The presi- 
dent summed up the results of the discussion 
on this subject as follows : First, they had as 
yet no stable criterion whereby to determine the 
therapeutic effects of any drug upon rheumatic 
fever. Secondly, therapeutic conclusions were 
apt to be vitiated by failing to distinguish be- 
tween two forms of the disease. Third, while 
the influence of salicylic acid and its compounds 
somewhat spee lily relieved the malaise of which 
the rheumatic sufferer complained, it was ex- 
tremely doubtful whether they in any degree 
diminished the peril of secondary cardiac or 
other inflammatory complications. Lastly, it 
was left uncertain whether they succeeded in 
removing that actual pathological state of which, 
in a sense, these other things might be said to 
be the expression. In short, there was almost 
a greater tendency to relapse with the salicy- 
lates than otherwise. — The British Medical Asso- 
ciation. 



I}. Lin. aconit. 3 ij. 

Lin. belladonnas 3 ij. 

Glycerinae ad. 1 ij. 

M. Apply locally over seat of pain. 

Fothergill. 



pkesceiber's memobanda. 229 

This liniment is especially advised when the 
pain is confined to the sciatic nerve, offering 
marked relief. Treacle may be substituted for 
the glycerine with advantage. A convenient 
mode of application is to spread the above on a 
V-shaped piece of lint and place on the thigh. 



5.. Acid, sulphur 3 j. 

Olei olives 5 j. 

Olei terebinthinEe § j. 

Add the acid gradually to the oil, stirring in 
mortar. When cold, add the oil of turpentine 
and mix. 



Prof. Bartholow states that no single remedy 
can be applied to every case of acute rheuma- 
tism. For successful treatment the form and 
type must be taken into consideration. 

1. In the feeble, anaemic, nervous subject, he 
gives tinct. ferri chlorid. , 7T(_xxx., every four 
hours ; orders the joints to be kept at rest, 
wrapped in cotton, if the patient desires it ; and 
if they are very painful, small blisters (the size 
of a silver dollar) to be applied around them. 
An occasional laxative of Rochelle salt is added. 
The iron cuts short the disease, lessens the dan- 
ger of cardiac complication, and also has the 



230 prescriber's memoranda. 

power, as Anstie pointed out, of preventing im- 
pending attacks. The blisters relieve pain and 
bring about a more alkaline condition of the 
blood and urine. Thus treated, cases of this 
type rarely last more than two weeks, heart- 
complication is infrequent, convalescence is 
rapid, and relapses uncommon. 

2. Fat and flabby subjects require the alka- 
line plan: two drachms of potassium carbo- 
nate, one-half drachm of citric acid, and four 
ounces of water every three or four hours, until 
the urine ceases to be acid, when the amount is 
to be reduced one-half, the reduction being then 
continued daily until the fourth or fifth day, 
when, if the urine continue alkaline, quinia (six 
grains every four hours), or preferably tinct. 
ferri should be added. If the attack is severe, 
blisters are applicable. With this treatment, 
this class get well within two weeks. 

3. Vigorous subjects, often with hereditary 
tendency. These cases are often promptly re- 
lieved by salicylic acid in scruple doses. Not less 
than 3 ij. should be administered in twenty-four 
hours, and considerably more may be required. 
It is more effective given in solution with an ex- 
cess of alkali. A cure is thus not unfrequently 
effected in three or four days, but some stomachs 
cannot bear it, and if it depress the heart, it 



prescriber's memoranda. 231 

must be stopped. If after three or four days 
it produce no improvement, it is useless to per- 
sist in it. In all forms the diet should be liquid. 
Opium is objectionable by checking elimination ; 
atropia promotes elimination, and is therefore 
preferred as an anodyne, being given hypoder- 
mically in the neighborhood of the affected 
joints, and it is rarely necessary to exceed gr. 
-gV per day. 

Should cardiac complication arise, the carbo- 
nate of ammonia (gr. v. doses frequently), and 
infusion of digitalis, with hypodermic injection 
of morphia, should be given at once to dissolve 
fibrin, check inflammation, and lessen the work 
of the heart. When the acute symptoms have, 
subsided, substitute iron and quinine for the 
ammonia and morphia. Experience also shows 
a blister, on or near the prsecordia, to be useful. 

In sudden hyperpyrexia (fortunately very 
rare), where the temperature leaps without 
cause to 106°— 109° F., the cold bath is neces- 
sary to ward off certain death. 

Dr. Paul L. Brick recommends a steam-bath 
as the treatment for acute, articular, and mus- 
cular, as well as chronic rheumatism : 

Put from two to four red-hot bricks into a dry 
wash-tub, upon something to prevent the bricks 



232 prescriber's memoranda. 

burning the tub, then put the affected limb or 
the whole patient, as the case may require, in a 
nude state, over the tub upon a board or chair, 
the whole to be covered with a blanket. Then 
sprinkle water on the bricks, creating steam, 
and producing a profuse perspiration upon the 
patient ; continue during twenty to forty min- 
utes, and repeat once in two days. 



^ . G-ambogige, 
Myrrhaa, 
Canellse, 

Sodas salicyl aa § *]• 

Olei terebinth., q. s. to liquefy. 
M. S. — Use with steady friction twice daily, 
and then cover with, wadding. 



Dr. Gaston says that propylamine, in acute 
rheumatism, will subdue the pain in twenty-four 
to forty-eight hours. Dr. Tyson also recom- 
mends it where the salicylate of sodium is for 
any reason inapplicable. His formula is : 

I£. Propylamin. chlorid gr. xxiv. 

Aquee menthas 3 vj. 

]VI. S. — § ss. every two or three hours. 
Benefit was apparent in twenty-four hours. 



pbescribek's memoranda. 233 

Dr. Wm. Corson uses this formula in rheu- 
matism with much success : 

1^ . Ammonia? phosphat. 3 jss. 

Tinct. colchici sem § j. 

Tinct. aconit. rad 3 ij. 

Syr. simplicis § iij. 

M. S. — 3 j. every three or four hours. 



Prof. Gubler used, in chronic arthritis, ten 
parts of iodoform to twenty of sulphuric ether 
and twenty of alcohol. When dissolved, the lini- 
ment should be applied to the diseased joint by 
means of a pencil. The parts should then be 
covered with a piece of oiled silk. For the same 
affection, Dr. Cottle dissolves iodoform in chlo- 
roform. 



RINGWORM. 

The remedies in common use act in two 
ways : 1st, by setting up a sufficient inflamma- 
tion in the skin to lead to the destruction of the 
disease ; 2d, by simply antagonizing- the tri- 
chophyton tonsurans. Remedies which act in 
the manner first indicated are such as acetum 
cantharidis and strong acetic acid ; sulphur 



234 • peescribek's memoranda. 

ointment, the white precipitate ointment, and 
sulphurous acid lotion belong to the other class. 
Many remedies combine these two actions, as, 
for example, chrysopharric acid ointment, iodine 
liniment, and strong" carbolized glycerine. 
Strong remedies are always contra-indicated. 
It is always very unwise to trust strong reme- 
dies in unskilled hands. When the disease ex- 
tends over a large surface, milder measures 
must be resorted to — tincture of iodine of dou- 
ble strength is a good and safe mode of treat- 
ment. This may be followed by the use of the 
nitrate of mercury ointment, diluted according 
to circumstances, or an ointment containing the 
red and white precipitate of mercury and sul- 
phur, or the oleate of mercury (10 per cent.). 
Goa powder or chrysophanic acid, in strength of 
thirty grains to the ounce, is very effective in 
some cases. When carefully watched so as to 
guard against the severe inflammation it is lia- 
ble to set up, it is a good application. 
Inasmuch as ringworm is usually associated 
with a generally unhealthful condition of the 
skin, which is badly nourished, such tonics as 
iron and arsenic are indicated. This is quite in 
accordance with the fact that many local dis- 
eases are influenced by general treatment. 

LlVEING. 



prescriber's memoranda. 235 

Mr. James Startin has found the following 
treatment most successful in a large number of 
cases of ringworm of the scalp : 1. Well wash 
the parts affected with just enough soft soap 
to make a wash ; thoroughly dry, and then 
apply, with a thick camel-hair brush, some 
blistering fluid. 2. After a few days, when 
the inflammation has subsided, use alter- 
nately the following applications : ol. cadini, 
creasote, and tincture of iodine in equal parts, 
and a lotion of hyposulphite of soda, two 
drachms to the ounce of water, with a little 
compound tincture of lavender. 3. If the skin 
should be sore from the use of the above appli- 
cations, then the use of the white precipitate 
ointment of the British P/iarmaeopceia, diluted 
with equal parts of vaseline, will prove most 
beneficial. Mr. Startin does not think we can 
ever give a prognosis of complete cure of these 
cases of obstinate ringworm under three 
months ; but he has never found the above to 
-fail. 



Mr. J. Naish Smart thinks that a very effec- 
tual remedy exists in perchloride of mercury 
in solution of two grains to the ounce of water 
with the addition of a little spirits of wine 
or ether to make it soluble. This solution 



236 prescriber's memoranda. 

carefully applied with ' a camel-hair pencil two 
or three times a day, Mr. Smart has never 
known to fail even in most stubborn cases. 



SCIATICA. 

Br. Wm. Pepper says: " When there is distinct 
local inflammation, I am accustomed to treat 
the disease with large doses of iodide of po- 
tassium and minute doses of the bichloride of 
mercury. If we desire to cause absorption of 
inflammatory matters inside the sheath, the 
best way to do so is by means of severe blister- 
ing", or by the actual cautery. The actual cau- 
tery, in particular, has great absorbent action, 
and powerfully relieves over-sensibility of the 
nerves. Another excellent treatment is by 
hypodermic injections of morphia and atropia 
right down into the adjacent muscular struc- 
tures. For this purpose we are in the habit of 
using here from one-sixth to one -fourth of a 
grain of morphia, and from one-ninetieth to 
one-sixtieth of a grain of atropia. In employ- 
ing this formula, you must be careful, as the 
disease subsides, that the opium-habit is broken. 
Indeed, the formation of such a habit should 
be guarded against by intermitting the treat- 
ment from time to time. In still other cases, 



prescriber's memoranda. 237 

again, where the localized pain has been 
intense, I have derived most excellent resnlts 
from the hypodermic injection of from eight to 
twelve minims of chloroform, taking great care 
to keep the needle out of the way of the 
arteries. Though incomparable as a tempo- 
rary destroyer of pain, the effects of the chloro- 
form are not very permanent. Galvanism is 
very quick in some instances to relieve pain. 
The mode of application should be with the 
positive pole at the seat of the pain and the 
negative pole along the nerve -trunk. Where 
the muscles have wasted to any great extent, 
the faradic current is the best." 

Dr. Ebrard, physician to the Hospital of 
Nimes, for many years has treated the pains of 
sciatica and other neuralgias without having re- 
course to any other electric battery than a 
smoothing-iron, which, along with vinegar, is to 
be found in every house. This is how they are 
employed : The iron is heated hot enough to 
vaporize the vinegar, and is wrapped up in some 
material, preferably woollen ; it is then dipped 
in the vinegar, and applied on the painful part. 
The operation is repeated two or three times in 
the day. It rarely happens that the pain has not 
disappeared at the end of twenty-four hours. 
This action is easily understood. On account of 



238 peesckiber's memoranda. 

its contact with the fire the iron becomes mag- 
netic ; and if an acid be added while it is hot, 
electricity is produced, and the same effects are 
obtained as with an electric battery. 

There are two varieties of sciatica : one in 
which the nutrition of the limb is unchanged ; 
the other, accompanied by atrophy of the limb. 
In the first class the neurilemma alone is affected; 
in the second, the nerve- fibres are attacked by 
the inflammation and cause atrophy of the limb. 
There are two kinds of pain, one present only 
on motion of the limb, the other when the limb 
is at rest. In all cases the first element of cure 
is rest. To this, in cases of the first class, must 
be added blisters and hypodermic injections. 
The pain being allayed, dry fumigations should 
be used. Dry heat is better than douches of 
sulphurous or terebinthinate vapors. In de- 
fault of the former, vapor-douches give the 
best results. 

Dr. Lange suggests nerve -stretching by flex- 
ing the thigh upon the abdomen forcibly. 



SEA-SICKNESS. 

The inhalation of nitrite of amyl is strongly 
recommended by Mr. C. Clapham, who is sup- 
ported, though less enthusiastically, by Dr. Lee- 



prescriber's memoranda. 239 

son. The latter reports to the Lancet that he 
gave it until full flushing- was produced. In 
three-fourths of his cases no vomiting occurred 
afterward ; in another fourth they still felt sick, 
and in a final fourth it seems to have been use- 
less. He finds toleration of the drug soon be- 
comes established. Great caution should be 
used with this drug, and there is a tendency to 
give too large doses. Two minims will usually 
suffice when it is first given. 



Chloral hydrate, in fifteen-grain doses, has 
been used with success in a number of cases. 



Bromism has been strongly recommended by 
Dr. George M. Beard. 



SEMINAL DISORDERS. 

Bumstead gives the following prescription for 
its special tonic effect upon the genital organs : 

I£ . Tinct. f erri chlor § iij. 

Ext. ergot, fl. (SquibVs) § iij. 

M. S. — A teaspoonful in water after each 
meal. 



240 peesceiber's memoeanda. 

As a direct means of diminishing the fre- 
quency of the emissions, the doctor recom- 
mends : 

^ . Potass, bromid J j. 

Tinct. ferri chlor § j. 

Aquae 3 iij. 

M. S. — From one to two teaspoonfuls in 
water, after each meal and at bedtime. 

The avoidance of tobacco in all its forms, 
cleanliness of mind and body, laxatives when 
needed, and, in a word, attention to the rules of 
hygiene, are to be strictly enjoined. 



$ . Potass, bromid § j. 

Ext. belladonnas fl., 

Ext. gelsemin fl aa 3 ij. 

Syr. simp § jss. 

Aquae menthae pip 3 ij. 

M. S. — Teaspoonful t. i. d. Anaphrodisiac. 

Bartholow. 



^ . Zinci sulph gr. xij. 

Morphias sulph gr. iv. 

Atropiae sulph gr. ss. 

Aquae dist § j. 

M. Prostatic injection. Bartholow. 



prescreber's memoranda. 241 

3. Argent, nitrat gr. x. 

Aquas 3 j. 

M. Prostatic injection. Bartholow. 



]$ . Tinct. canthar gtt. vj. 

Tinct. f erri chlor gtt. xv. -xx. 

M. S. — Thrice daily in water. H. C. Wood. 

This prescription has been found to cure im- 
potence with spermatorrhoea so speedily as to 
commend itself to the use of all medical men 
in the treatment of these cases. 



5 . Tinct. cantharidis v . . . 3 j. 

Tinct. cannab. Indie, 

Sol. morphias, bi-mec aa 3 ij. 

M. S. — Fifteen drops, t. i. d. Aphrodisiac. 

Bartholow. 



B» Tinct. nucis vom 3 j. 

Tinct. actea racemos 3 iij. 

M. S. — Twenty drops, t. i. d. Aphrodisiac. 

Bartholow. 
16 



242 pbescriber's memoranda. 

SINUSES. 

Sinuses in which Necrosed Bone cannot be 
found, ViUate J s Mixture in the Treatment of. — 
The original composition of the mixture was : 

J$. Liq. plumbi subacet § j. 

Zinci sulph. cryst., 

Cupri sulph. cryst aa 3 ss. 

Aceti vini albi fl. 3 vjss. 

The mixture was injected once a day, and 
proved a more satisfactory application than any 
other. Some patients complained of severe 
pain, others felt but slight inconvenience from it. 

SLEEPLESSNESS (See Insomnia). 
Alcohol administered in one or two teaspoon- 
ful doses at bedtime gives excellent results, es- 
pecially in elderly patients. 



ty . Sodas bromid. § j. 

Pepsin sacchar 3 iij. 

Liq. carb. pulv § ss. 

Digitalis tinct § ss. 

Ergot, ext. fl., 

Acid, phosphor, dil aa fl. § ij. 

M. S. — Teaspoonful, t. i. d., before meals, 
in one-third of a glass of water. Hammond. 



prescriber's memoranda. 243 

Chloral hydrate is a valuable remedy for this 
affection. It may advantageously be combined 
with the bromide of potassium. 



SKIN DISEASES (See also Eczema, Herpes, 
etc.). 
Rosacea of the Face. — Wash the face sev- 
eral times with very warm water, then — 

1$, . Sulph. sublim § j« 

Tinct. camph 3 ij.-iv. 

Etheris sulph > j. 

Aquas q. s. ad. § viij. 

M. Bathe the face at night with this and let 
it dry on. In the morning wash and apply — 

B . Zinci oxid 3 ss. -j. 

Ung. petrolei \ j. 

M. Improvement begins in a week, but the 
treatment should be continued several months. 



Topical Use of Ergotine in Acne Rosacea, etc. 

Dr. Eldridge used hypodermic injections every 
three days of the following : ergot, gr. xv. ; 
glycerine, 3 ss. ; aquae, 3 ij. In a week or ten 
days after the injection the surface presented 
a softened, whitened, shrunken condition. 



244 prescriber's memoranda. 

Eczema Intertrigo of Infants. 

I£ . Plumbi acetat , . . . gr. xxx. 

Acid. acet. dil 3 ij. 

Glycerine 5 jss. 

Aquae rosge ad. § viij. 

M. Wash the sore parts well with soap and 
water, dry carefully, then apply the above. 



]£ . Powd. quicklime 3 viij. 

Washed sulphur 5 iv. 

M. and add one gallon of boiling water. Stir 
and allow to settle, and then decant. Use as a 
wash, allowing it to dry. At the end of three 
or four hours the dust may be washed from the 
skin. A second application may be necessary. 
It does not irritate the skin. 



Scabies. 

$ . Hydrarg. bichlor 3 ij. 

Pulv. capsici 5 iv. 

Pulv. sulph 1 iv. 

Adipis lb. iv. 

Mix by gentle heat, and keep stirring until 
cold. 



Dr. Lamberti reports a case of herpes zoster, 
or " shingles," which he cured in a single day 



peesceibeb's memoranda. 245 

by means of carbolic acid. He painted carefully 
the vesicles with the liquid, using a camel-hair 
brush, and then covered the whole part with a 
thick layer of cotton-wool. Tt caused severe 
burning" pain for two hours, after which ease 
was obtained, and the patient, having received 
a dose of chloral hydrate, fell asleep, and awoke 
the next day feeling quite well. Nothing more 
was done, but the cotton- wool was left on for 
three days. On its removal then, the vesicles 
were all dried up, the crust adhering to the 
cotton- wool, and the spots that remained were 
not in the least tender. A. saline purgative and 
a drink containing bicarbonate of soda were the 
only medicines taken. No return has occurred 
after two years. 



5 . Sulph. sublim § j. 

iEtheris fl. 3 iij. 

Glycerinse fl. | j. 

M. Ft. paste. 

^ . Sulph. sublim 3 iij. 

Spts. camph fl. 3 i j. 

Sodae biborat 3 j. 

Glycerinse fl. 3 iij. 

Aquae fl. J vj. 

M. Ft. lotion. 



246 prescriber's memoranda. 

R . Iodinii gr. cxxviij. 

Brominii gr. ccxl. 

Alcoholis (94$) fl. § viij. 

M. 

1$. Saponis viridis § ij. 

Alcoholis fl. 1 iv. 

M. 

Compound Tincture of Soap. 

3 . Saponis viridis. § j. 

Alcoholis, 

Olei cadini aa fl. § j. 

M. 

I£. Pulv. ararobae (goa-powder). 1 to 4 parts. 
Oleo-paraffini (vaseline) 10 parts. 

Melt the vaseline on a water-bath, add the 
goa-powder, stir and heat for about ten min- 
utes ; then strain quickly into a capsule stand- 
ing on ice, and stir briskly until cold. 



IjL Empl. plumbi., 

Oleo-paraffini (vaseline) aa § j. 

Melt the lead-plaster together with the vase- 
line, then stir them in a warm mortar continu- 
ally until cool. Piffard. 



rRESCRIBER's MEMORANDA. 247 

3 • Emplast. plumbi § v. 

Olei olivae fl. 5 iv. 

Olei lavandulag fl. 3 j. 

Melt the lead -pi aster and oil together at a 
gentle heat ; then stir until the mixture begins 
to stiffen, and incorporate with it the oil of 
lavender. Hebra. 



^ . Hydrarg. amnion. gr. xl. 

Oleo-paraffini (vaseline) \ j. 

M. 



^ . Hydrarg. oxid. rubri gr. lx. 

Oleo-paraffini (vaseline) 1 j. 

M. 



I£. Hydrarg. oxid. rubri, 

Plumbi acetat aa gr. viij. 

Cerati § j. 

M. McKay. 



]£. Liq. picis alkal. (see p. 248).. fl. 3 j. 

Cerati 5 j. 

M. • 



I£ . Potass, iodid 3 ij. 

Ung. stramonii 5 j. 

M. 



248 peesceebee's memoranda. 

3 . Ung. hydrarg. nitrat 3 jss. 

Ung. acidi carbol § ss. 

Ung. zinoi oxid § j. 

M. 

Z^. P&cw Alkalinis. 

^ . Liquid tar 3 ij. 

Caustic potash 3 j. 

Distilled water 3 v. 

All by weight. 

Add the potash to the water and make solu- 
tion, and then add the tar and grind in a mor- 
tar. One part to twelve or sixteen of water for 
external use in eczema. Stronger, if necessary, 
for chronic cases. Bulkley. 

V f . Iodinii, 

Potass, iodid aa 15 ( § ss.). 

Glycerinse 5(3]'-). 

M. Lupus. Anderson. 

Ungt. BocJiardi. 

5 . Iodinii 0.70 (gr.'x.). 

Hydrarg. chlor. mitis . . 2 ( 3 ss.). 

Unguenti 50 ( * j. 3 vj.). 

M. Lupus. 



prescriber's memoranda. 24:9 

]£. Zinci chlorid., 

Zinci oxidi aa q. s. 

M. Lupus. Squire. 

^. Vini ferri (B. Ph.) 45 ( I jss.). 

Syr. tolutani 15 ( 3 iij.). 

Liq. potass, arsenit 4 ( 3 j.). 

Aquas anethi 60 ( § ij. ). 

M. Dose, one to two teaspoonfuls. 

Eczema. Wilson. 

I£. Hydrarg. ammon 1 (gr. xv.). 

Glyc. amyli 30 ( I j.). 

M. Eczema, etc. Muller* 

3£ . Acid, boracic 1 (gr. xv. ). 

Aquas 30(?j.). 

M. Eczema and pruritus ani. SQUIRE. 

^. Aconitias 0.06 (gr. j.). 

Unguenti 4 (3 j.). 

M. Pruritus. Satterlee. 

5 . Tinct. digitalis 8-15(3 ij.-iv.). 

Glycerini 20 ( 3 ss.). 

Aquae rosae 180 ( § vj.). 

M. Pruritus. T. Fox. 



250 prescriber's memoranda. 

$. Iodinii 0.75 (gr. xij.). 

Potassii iodid 0.40 (gr. vij.). 

Alcohol 30 (§].). 

Aquae 150 ( J v. ). 

M. Pruritus scroti. Barosii. 

I£ . Acid, carbol 4-8 ( 3 j.-ij- )• 

Glycerini 40 (§].). 

M. Localized pruritus. Bronson. 

I£. Hydrarg. sulph. flav 1 (gr. xv.). 

Olei theobromae, 

Olei ricini, 

Olei amygdal aa 20 ( 3 v.),. 

M. Pityriasis. Malassez. 

I£. Hydrarg. chlor. corros. . . 0.06 (gr. j.). 

Tinct. benz 8 ( 3 ij. ). 

Aquae 125 (§vj.). 

M. Acne. T. Fox. 

1^ . Ergotin 1 (gr. xv.) . 

Glycerini 2.50 ( 3 ss.). 

Aquae 8 ( 3ij.). 

M. TT^ij.-iij. as a hypodermic injection in 
rosacea. Eldridge. 



prescriber's memoranda. 251 

I£ . Acid, benzoic 0.12 (gr. ij.). 

Aquse 30 (§j.). 

M. Lotion for urticaria. Squire. 

$ . Sodse salicyl 5 (gr. lxxx.). 

Acid, carbol 2 (gr. xxx.). 

• Unguenti 40 ( I j. 3 ij.)- 

M. Alopecia areata. Eichorst. 

^ . Hydrarg. chlor, corros 1 (gr. xv.). 

Capri acetat 4 ( 3 j.). 

Cerati 60 (lij.). 

M. Parasiticide. 

3 . Calcii sulphid 6(3 jss.). 

Collodion 30 ( § j.). 

Favus. Gamberini. 

fy. Hydrarg. chlor. mit 3 (gr. xlv.). 

Ungt. aquse rosse 30 ( 5 j-)- 

M. Ephelis. Corbel-Lagneau. 

1^. Hydrarg. chlor. corros. 0.50 (gr. viij.). 

Zinci sulphat. , 

Piumbi. acet aa 2 ( 3 ss.). 

Aquas 250 (I viij.). 

M. Ephelis. Hardy. 



252 prescriber's memoranda. 

5 . Barii sulphid 6(3 jss. ). 

Zinci oxid 24 ( 3 vj. ). 

Mix with water to a paste. Apply for three 
minutes and then wash off. 
Depilatory. Anderson. 

3 . Potass, sulphid 6(3 jss.). 

Zinci iodidi 24 ( 3 vj.). 

M. Depilatory. Colan. 

Vienna Paste. 

^ . Potassse, 

Calc. caust aa q. s. 

M. When used, mix with an equal weight of 
strong alcohol. 

1$, . Antimonii chlorid 2 ( 3 ss ). 

Zinci chlorid 4 ( 3 j.). 

M. Add a little flour to make a paste. 
Caustic. Cazenave. 

^. Potass, iodo-hydrarg 1 (gr. xv.). 

Sacch. lact 10 X 3 ijss.). 

Syr. acacige q.s. (q. s.). 

M. Make 100 pills. 

Syphilis — one to five pills daily. 

Hallopeau. 



prescriber's memoranda. 253 

STRANGURY. 

Mr. G. Dannecy proposes the following 1 to 
prevent strangury from blisters : The blister- 
ing- plaster, having been spread of the shape and 
size indicated, is dusted with a mixture of 
equal parts of coarsely powdered cantharides 
and carbonate of soda. The powder is then 
strongly pressed with the palm of the hand, to 
insure the adherence of the powder, and the 
surface is covered with oiled tissue-paper. This 
method has been used exclusively for several 
years past, and only one complaint has ever 
been noted, no matter what may have been the 
size of the blisters. 



STOMATITIS. 

Dr. S. Ullman reports that in children of an 
early age, and during the process of dentition, he 
has employed the following prescription in stom- 
atitis, with a most happy result : 

IJ. Acid, salicyl gr. v. 

Acid, tannic gr. v. 

Soaa3 bibor 3 ss. 

Potass, chlorat 3 j. 

Sacchari albi 3 ij. 

M. Fiat pulvis. S. — Apply a pinch on the 
tongue twice or thrice a day. 



254: prescriber's memoranda. 

In some affections of the throat of an ulcera- 
tive nature this combination is excellent. The 
whole may be added to two or four ounces of 
aqua distillata, and the directions given accord- 
ingly. 



SYPHILIS. 

$ . Hydrarg. proto-iodid gr. xx. 

Tragacanthae q. s. 

M. Ft. pil. no. cxx. 

Commence with one after each meal and in- 
crease one every third day until the teeth com- 
mence to get sore, or the bowels disordered, when 
you drop two pills from each dose and continue 
their administration regularly. Keyes. 



Or, 

~fy . Mass. hydrarg gr. 1. 

Ft. pil. no. c. Use in the same way. 



Or, 

I}. Mass. hydrarg.. 

Ferri sulph. exsic aa gr. 1. 

Ext. gentian q. s. 

M. Ft. pil. no. c. If the patient is anaemic. 

Keyes. 



prescriber's memoranda. 255 

5 . Hy drarg. bichlorid gr. j. 

Tinct. cinchona co. , 

Aquae .. . . . aa § iij. 

M. S. — Teaspoonful after meals. In cases 
of anaemia the tincture of the sesquichloride of 
iron (3 iij.) may replace the tincture of cin- 
chona. Keyes. 



l< Ricord's Mixture," which has been so highly 
recommended in syphilitic affections, is com- 
posed as follows : 

^ . Hydrarg. iodid. rub gr. iv. 

Potass, iodid § j. 

Fl. ext. sarsap. comp § j. 

Aquae q. s. ad. 3 v 

M. S.— Teaspoonful. 



3 . Potass, iodid 3 ij. 

Hydrarg. biniodid gr. ss. 

Syr. aurant. cort § j. 

Tinct. aurant. cort 3 j. 

Aquae ad. 3 iv. 

M. S. — Teaspoonful in water after eating. 
Mixed treatment. Keyes. 



25G peescbibek's memoranda. 

Or, 

I£. Hydrarg. biniodid . . . . gr. iij. 

Potass, iodid gr. cl. 

Gum tragacanth, 

Glycermae au, q. s. 

M. Ft. pil. no. 1. Keyes. 



fy. Hydrarg. biniodid gr. iij. 

Potass iodid 5 ijss. 

Aqua* dist 3 ijss. 

Syr. simplicis q. s. ad. fl. § x. 

M. S. — A tablespoonful three times daily. 
Tertiary syphilis. 



TAPE-WORM. 

Ijt . Pumpkin seeds 3 xx. 

Sugar gr. cc. 

Etherial ext. of male fern. ... 3 ij. 

Decoct, pomegranate root. ... 3 x. 
M. Ten grains of calomel are administered, 
after which the patient fasts for twenty-four 
hours, taking nothing except slippery- elm tea. 
One half of the above mixture is given in four 
equal doses, at intervals of fifteen minutes, and 
if it does not produce catharsis within two 



prescrlber's memoranda. 257 

hours, prompt purgation is produced by either 
castor-oil or rochelle salts. E. H. M. Sell. 



Dr. Ridder has used salicylic acid with satis- 
factory results. The mode of administration is 
as follows : An ounce of castor- oil is given in 
the morning, and the patient's diet restricted 
during the day, so as to keep the intestinal canal 
as empty as possible. On the following morn- 
ing half an ounce of castor-oil is given at seven 
o'clock ; at eight o'clock twelve grains of sali- 
cylic acid are given, and this dose is repeated 
every hour until a drachm of the acid has been 
taken ; half an hour after the last dose, another 
half ounce of castor-oil is administered. After 
the passage of the worms the rectum is washed 
out with injections of water. The only un- 
pleasant effect produced by the treatment is a 
slight nausea, which is not, however, bad enough 
to keep the patients from returning to work on 
the same afternoon. 



Osinum basilicum is a new anthelmintic. This 
plant, which is known in Buenos Ayres under 
the name albaliaca, exerts a powerful action 
on intestinal worms, expelling them from their 
haunts with very great rapidity. The part 
17 



258 peesceibee's memoeanda. 

used is the juice, and it is given in doses of 
about two ounces, followed in two hours by 
castor-oil. It acts more powerfully and cer- 
tainly as a vermifuge than calomel, santonin, 
kousso, or kamala, and, on the other hand, pos- 
sesses the great advantage of doing no harm if 
worms be not present, exerting then merely an 
aperient and disinfectant action. 



THE TONGUE IN DISEASE. 

Henning says : " 1. The elongated and pointed 
tongue invariably indicates irritation and deter- 
mination of blood to the stomach and intestines. 
The extremities are often cold. It is also asso- 
ciated with excitation of the nerve-centres. 
This tongue is often found, but more especially 
among children. The indications are to allay 
irritation and divert the blood from the stomach 
and bowels. We should be very careful how we 
make our prescription in such cases, as, if we give 
an irritant cathartic, it invariably aggravates the 
disease. 2. The pinced and slirunken tongue 
indicates atony of the digestive organs, often 
found in dyspepsia and kindred diseases. The 
treatment is plain, the pathological conditions 
evident at a glance, from the appearance of the 
tongue. 3. The coating (saburra) or fur should 
be well studied. It may be greater or less in 



pbescriber's memoranda. 259 

thickness, dry or moist, or clammy, more accu- 
mulated at the posterior portion. It is said that 
when the tongue is heavily coated at the base, 
with a deep yellow coat, the liver is at fault. 
This is not always the case ; and, from my ob- 
servation, more often not the case. I have seen 
cases of jaundice with a white-coated tongue. 
Tobacco-chewers nearly always have a yellow- 
coated tongue, and their liver may be sound. 4. 
The dry tongue has a very important significance. 
When we have patients who are suffering from 
some form of fever, pneumonia, or any other acute 
disease, with such a tongue, they are in danger, 
and require close attention. In such cases nutri- 
tion and assimilation are suspended, and food can- 
not well betaken, and, if taken, cannot be properly 
assimilated. When given, it should be in fluid 
form, and always above the temperature of 
100°, and of a character nutritive and digesti- 
ble. The digestive organs can do but little 
work, yet proper food, given at proper intervals, 
does good ; but these organs need all the rest 
they can get until the disease has subsided. Dry- 
ness of the tongue is also associated with vascu- 
lar excitement, and particularly with excitation 
of the ganglionic and nerve-centres. Hence the 
arrest of secretion and this dryness. Here we 
readily read the state of the nervous system. 



260 peesceibee's memoeanda. 

In many cases, the sympathetic nerve is not only 
excited and irritated, but there is involuntary 
contraction of muscular tissue, thus suspending 
the secretions of the several organs. The indi- 
cations are, proper sedatives for the vascular 
excitement, and diaphoretics for contractions or 
excitement of the nerves, associated with other 
proper treatment. By this course we shall soon 
see our patient with a moist tongue, arid some 
of the secretions re-established. 5. Often the 
tongue changes in the disease from the dryness 
above referred to, to a brown or black color, with 
sordes about the teeth. The common idea is 
that the system is in a typhoid condition. This 
is true ; yet it undoubtedly means, also, that 
the blood is in a septic condition — a very im- 
portant fact for us to know. Then our best an. 
tiseptics should be given with stimulants and 
tonics. Thus we can readily read, from the ap- 
pearance of the tongue, the condition of the 
digestive organs, the functions of nutrition and 
assimilation, the condition of the nervous sys- 
tem, and the state of the blood. Of course, we 
must take all other symptoms into considera- 
tion. Yet the appearances of the tongue, as 
pointed out, seldom fail in giving us, at a glance, 
valuable information as to the true condition of 
the system." 



pkesckibek's memoranda. 261 

TONSILLITIS. 

Dr. H. C. Hov/ard declares that, with one 
thorough application of nitrate of silver (solid 
stick) to the tonsils :n the first stage of acute 
tonsillitis, he has rarely failed to prevent suppu- 
ration. 



Dr. Hale has prescribed baryta iod. in hyper- 
trophy of the tonsils, with very gratifying results. 
It effects a rapid diminution in the size of the 
glands, even when they have been indurated for 
some years. 

Equal parts of tinct. guaiaci and glycerine, 
given in teaspoonful doses every hour or two 
hours, produces excellent results in acute ton- 
sillitis. 



Rubbing the tonsils daily with citric acid is 
highly lauded in enlargement of the tonsils. 



TYPHOID FEVER. 

Sir William Jenner asserts the impossibility of 
cutting short a case of typhoid fever by means 
of treatment. In treating cases it must be 
borne in mind, first, that the disease, in the 
majority of cases at least, is produced by the 



262 prescriber's memoranda. 

action of a small portion of the excreta from 
the bowels of a person suffering from typhoid 
fever; that air from a drain, or air blowing 
over dried feculent matter, may convey the 
poison to the patient ; or his own fingers may 
carry it to his mouth ; or that the vehicle 
for the poison may be a fluid — for example, 
milk or water ; and that the poisonous proper- 
ties of the excreta may be destroyed by boiling 
the fluid in which they are contained, though 
not by filtering the fluid; secondly, that the 
natural duration of a well-developed case of 
typhoid fever is from twenty- eight to thirty 
days. By self -treatment in the earliest stages 
of typhoid fever the patient is prone to do him- 
self great mischief, either by taking violent 
exercise, strong stimulants, or drastic medi- 
cines, according to his fancy. Many of the 
worst cases have appeared to owe their gravity 
to exercise taken at a time when the nervous 
system could ill afford any strain, and hence, no 
typhoid fever case ought to be removed a great 
distance, if away from home. The diet should 
be liquids, with farinaceous food and bread in 
some form, if wished ; broths with vegetable 
juices, strained fruit-juices, avoiding grapes on 
account of skins and seeds. Milk must be used 
with caution. If the curd be undigested, great 



prescriber's memoranda. 263 

evils arise, and the patient is placed in jeopardy. 
" Do not forget that a pint of milk contains as 
much solid animal matter as a Midsized mutton- 
chop. What typhoid fever patient can digest 
two to four mutton chops per diem f A patient 
is weak from the fever, and not from lack of 
food. Pure water may be given ad libitum. 
If the bowels are confined, use simple enemata. 
Small doses of mineral acids are grateful and 
perhaps beneficial. Thus, the fever is to be 
met by rest, quiet, fresh air, mixed liquid food 
and blood-diluents, and by the exclusion of 
fresh doses of poison ; the intestinal lesion, by 
the careful exclusion from the diet of all hard 
and irritating substances, and the removal from 
the bowels of any local irritant. Headache may 
be alleviated by either hot or cold applications, 
and ceases spontaneously in about ten days. 
Sleeplessness, also, generally disappears in the 
second week ; still, if it be persistent, henbane, 
bromide of potassium, and chloral are valuable, 
alone or combined. With high temperature, a 
tepid bath or sponging the surface will often 
induce sleep. Opiates are to be avoided. No 
treatment can arrest or limit the specific changes 
in the intestinal glands ; but over the diarrhoea, 
which usually accompanies these changes, we 
can, in many cases, exercise a decided influence 



26 i prescriber's memoranda. 

by careful attention to diet, as above directed, 
and avoidance of accumulation of undigested 
food. So long as not more than three to five 
actions occur in twenty-four hours, the looseness 
is rather advantageous. If the stools be found 
to consist of curdled milk, the remedy is obvious; 
if too alkaline, dilute sulphuric acid sometimes 
affords marked relief ; if very offensive, impal- 
pable animal charcoal frequently acts as a 
charm. Sometimes constipation is present, 
with an extensive ulceration of the ileum ; 
then, small-sized enemata of thin gruel, every 
other day, are safer than large quantities less 
frequently. The most important and not un- 
frequent cause of inaction of the bowel in ty- 
phoid fever is deep ulceration of one or more 
Peyer's patches. Large, superficial ulcers favor 
diarrhoea; a single small, deep ulcer will para- 
lyze the action of the bowel — a most important 
point to bear in mind. This state of things, 
too, is frequently the cause of excessive tym- 
panites between the third and fourth weeks of 
the fever. Of all remedies, turpentine exter- 
nally is most generally used at these times, but 
in no case have I seen a diminution of the disten- 
tion, which seemed to be projiter 7wc. Charcoal 
to relieve fetor, pepsin to promote digestion, 
alcohol in fit doses to improve nerve-energy and 



prescriber's memoranda. 265 

so to increase the muscular power of the bowel, 
are each and all valuable in turn. A long tube 
passed up the bowel will often be the means of 
discharging- large quantities of flatus. In in- 
testinal hemorrhage, if it be never so small, the 
patient must be kept recumbent, and not al- 
lowed to make any effort when using the close 
pan. If he be unable to pass urine when 
recumbent, the catheter must be used. Starch 
enemata, with ten to fifteen drops of laudanum at 
once, and acetate of lead, with three to five 
drops of laudanum every two or three hours by 
the mouth, or gallic acid and iced water, are to 
be administered. It is highly requisite to keep 
the bowels empty, and, therefore, give essence 
of meat alone, and no milk. If the hemorrhage 
be sudden, copious, and repeated, ergotine, 
subcutaneously, with an ice-bag over the ileum, 
may be employed. The faintness due to hem- 
orrhage must not be removed by stimulants. 
Perforation is always fatal, in Sir William's 
experience. The value of treatment by cold 
baths has not carried conviction to the lectur- 
er's mind. Both quinine and salicylate of soda, 
employed to reduce high temperatures, have 
caused disappointment. Free action of the 
skin is often attended with great relief, and 
nothing assists this action so readily as a large, 



266 prescriber's memoranda. 

warm and moist flannel, covered with oiled 
silk, applied over the abdomen and chest, com- 
bined with the administration of warm, bland 
fluids. When, as in the latter stages, the per- 
spiration is profuse and exhausting, the patient 
must be lightly clothed and his skin wiped 
every few minutes, if necessary, with a warm 
napkin, and dry clothes placed between the wet 
linen and the skin. Alcohol must be given 
carefully to increase nerve-force, and sponging 
with tepid vinegar and water is sometimes of 
much service. To avert death from failure of 
the heart's power, alcohol is the great remedy. 
Delirium due to fever is never conjoined with 
headache ; headache in typhoid fever may be 
most intense, delirium most violent, but the 
headache ceases before the delirium begins ; if 
conjoined, we must look for that rare complica- 
tion — intra-cranial inflammation. Alcohol is, 
as a rule, the remedy for delirium, but must be 
used with caution ; more than twelve ounces 
of brandy are seldom necessary in twenty-four 
hours to meet all the demands upon alcohol, 
and, if there be a doubt as to quantity, it is 
better, in typhoid fever, to give the minimum 
amount the benefit rather than the maximum ; 
the reverse holding good in typhus fever. Tre- 
mor is sometimes excessive ; in such cases it is 



prescriber's memoranda. 267 

almost always a symptom of deep intestinal 
ulceration. A small, deep slough will be ac- 
companied with great tremor; a large ex- 
tent of superficial ulceration may be unat- 
tended by symptoms. " Sir William Jenner 
concludes in these words : ' ' While admitting 
without reserve that heroic measures, fearlessly 
but judiciously employed, will save life when 
less potent means are useless, the physician 
whose experience reaches over many years will, 
on looking back, discover that year by year he 
has seen fewer cases requiring heroic remedies, 
and more cases in which the unaided powers of 
nature alone suffice for effecting a cure ; that 
year by year he has learned to regard with 
greater diffidence his own powers, and to trust 
with greater confidence in those of nature." 



The remedies which have been found at the 
University Hospital to exert the most powerful 
influence upon the follicular intestinal catarrh 
always present in typhoid fever, are, first and 
foremost, the nitrate of silver, and next the sub- 
nitrate of bismuth and carbolic acid. There 
would seem to be abundant evidence that ni- 
trate of silver reduces the size of the enlarged 
follicles, relieves the inflammatory engorge- 
ment, and allays the hyperesthesia of the nerves. 



268 peesceiber's memoranda. 

It has also been settled by numerous experi- 
ments that the nitrate of silver is the most easily 
administered of the three astringents above 
mentioned, and the best tolerated by the sys- 
tem. If there is any putrid element in the dis- 
ease, carbolic acid is employed instead of the 
nitrate of silver. The nitrate of silver is ad- 
ministered in doses of one -fourth of a grain four 
times a day. This treatment is persevered in 
until the ulcers have entirely healed. 

If the discharge from the bowels is composed 
of small, semi-solid stools, it is, with propriety, 
disregarded; but if the stools are watery and 
large, opium is administered in pill-form, com- 
bined with the nitrate of silver. From one- 
fourth to one grain of the powdered opium is 
given three times a day. If there is constipa- 
tion instead of diarrhoea, belladonna is given 
conjointly with the nitrate of silver. 

Great care is had with regard to the diet when 
the catarrhal inflammation of the intestines is 
present. The food employed is of course as di- 
gestible as possible. Milk has been found to be 
the best diet in this disease. If the curd ap- 
pears in the stools, the milk is diluted with water 
or lime-water. Of this mixture of milk and 
lime-water three ounces are given every two 
hours, or a little over two pints in the course of 



prescriber's memoranda. 269 

twenty-four hours. When the bowels are tor- 
pid, beef or mutton broth is given alternately 
with the milk. 

The beef-tea employed is prepared after the 
following recipe : Take a quantity of tender 
meat, and, after cutting off the fat, chop it up 
fine, put it in a bowl, pour a pint of water over 
it, and let it stand overnight. The water should 
be kept just on a simmer, the temperature never 
being allowed to go above 140°, otherwise all the 
albumen is coagulated, and so either left on the 
sieve in straining, or introduced into the stom- 
ach in the form of curds. After this simmering 
solution has been allowed to stand overnight, 
pour it into the pipkin and heat again gently, 
with enough salt to give it flavor, and, if neces- 
sary, add a drop or two of muriatic acid. Then 
pour it out over a hair-sieve into a jar. The re- 
sulting solution will be found to contain all the 
nutriment possible, and to be the most valuable 
kind of stimulant and laxative. 

When the fever is high, the patient is given 
all the food he can take. Care is had, however, 
that in allowing food the already inflamed in- 
testinal tract is not further irritated. 

The poison in the blood is controlled by means 
of quinia and nitro-muriatic or salicylic acid. 
As a general thing, salicylic acid is only em- 



270 prescriber's memoranda. 

ployed where there is some putrid discharge 
joined with high fever. Quinia is considered : 1, 
to neutralize the effects of the septic poison in 
the blood ; 2, to act as a good tonic to the mus- 
cular and nervous systems ; 3, as tending to check 
febrile action; and 4, to remove any malarial 
element that happens to be present. Quinia is 
never given in the enormous doses advised by 
the German physicians. It has been found that 
such doses will break down high fever, but they 
produce entirely unnecessary irritation of the 
gastric mucous membrane. About twelve 
grains of quinia are given in the course of the 
twenty-four hours. 

The temperature is kept down by preventive 
measures rather than by the cold bath, which 
is regarded as a last resorfc. It is unnecessary 
after this to say that the practice of the Univer- 
sity Hospital is wholly opposed to the indiscrimi- 
nate cold bathing in typhoid fever, so much in 
vogue in Germany within a year past. 

When temperature runs up despite the use of 
drugs, in the milder cases sponging of the whole 
body are practised every two hours, the sponges 
being squeezed out of a mixture of water and 
bay -rum, at a temperature of from 60° to 80°. If 
this does not succeed (it rarely fails), and if the 
patient's temperature mounts up to 104° or 105°, 



pbesckeber's memoranda. 271 

he is then wrapped up in sheets wrung out of 
cold water. If the temperature still runs up to 
such an extent that life is threatened, the pa- 
tient is placed in a cold bath until the bodily 
temperature is sufficiently reduced. 

Before the local lesions appear, the fever can 
be more boldly attacked ; but when, in subse- 
quent stages, it runs high, it is regarded as par- 
taking of the nature of a sympathetic fever, 
largely dependent upon the amount of intestinal 
lesion, and the use of baths at this period is 
thought to be attended with great risk. If the 
cold bath is used at all (except as a last resort, 
and when temperature cannot be reduced in any 
other way), it is employed during the first ten 
days in cases where the temperature rises above 
103° and cannot be controlled by frequent spong- 
ings, large doses of quinia, diaphoretics, etc. 

With regard to the use of stimulants, the hos- 
pital practice is not in favor of administering 
them simply because a patient has the fever. 
It is believed that stimulants are only demanded 
for the relief of certain symptoms. As a gen- 
eral thing, they are not given to children before 
the age of puberty. They are administered only 
to old persons, and to meet certain indications, 
viz.: 1, ataxic nervous disturbances, such as 
sleeplessness, twitchings of the muscles, ma- 



272 peescbibek's memoranda. 

niacal delirium ; 2, circulatory disturbances, 
such as feeble and rapid pulse, and feeble de- 
velopment of the first sound of the heart; 3, 
profound asthenia, as shown by great tremu- 
lousness, inability to make any movement, and 
tendency to slide down off the pillow ; 4, dry 
and brown tongue, with sordes on lips, teeth, 
and tongue. 

The milder forms of stimulus are always used 
at first. The one most frequently employed is 
wine-whey. This is made in the proportion of 
one part of sherry to three of milk, and as much 
as a gill or half a pint of it is given in the course 
of three hours. If the symptoms increase, 
stronger stimulants are used, such as whiskey. 
Whiskey is usually given in lime-water and milk ; 
the lime-water prevents the coagulation of the 
milk by the alcohol. These ingredients are 
mixed in the proportion of one tablespoonful 
each of whiskey and lime-water to every three 
ounces of milk. In this form half an ounce of 
whiskey is given every hour. If the stimulation 
is doing good, a diminution of the serious symp- 
toms is noted. If the symptoms increase, on 
the other hand, the amount of stimulus is re- 
duced. 

With regard to complications : relapses are 
always regarded as true second attacks of the 



pbesckibee's memoranda. 273 

disease, and are treated accordingly. The treat- 
ment is resumed, the diet restricted, and the 
same general watchfulness had over the state 
of the case as during the course of the first 
attack. 

Hemorrhage occurring early in the attack is 
considered as of but little consequence ; but 
when it supervenes later — when the sloughs are 
thrown off — it is regarded as a very serious mat- 
ter. The treatment of hemorrhage is by abso- 
lute rest in bed for twenty-four hours, and by 
the administration of opium to produce complete 
quiet for the alimentary canal. The opium is 
given by the rectum, one grain of the solid opium 
being prescribed every two or three hours until 
the patient is gently under its influence. Of as- 
tringents for local action, acetate of lead is 
preferred. A suppository containing one grain 
of opium and three grains of the acetate of 
lead is given three or four times daily. Ergot, 
by reason of its action upon the walls of the ar- 
terioles, is also very highly prized. It is given 
hypodermically near the supposed seat of the 
hemorrhage. The food allowed is very small in 
quantity, and absolutely liquid. 

Peritonitis is treated by antiphlogistics, se- 
datives, perfect rest in bed, and a diet which 
leaves no residuum to irritate the bowels. 
18 



274 prescriber's memoranda. 

True perforation is regarded as beyond the 
reach of medical skill to mend. 



Br. Alonzo Clark reports one case in which 
opium cured the patient after perforation had 
occurred. 



TYPHO-MALARIAL FEVER. 

Br. Bartholow says that he has seen many cases 
of this disease, and has obtained the best results 
from the following ; 

I£. Tinct. iodini, 

Acid, carbolic equal parts. 

M. S. — Gtt. j.-ij. quarta vel sexta quoque hora. 

Quinine, he says, does nothing more than re- 
duce the pyrexia. When diarrhoea occurred, 
he used liq. potassas arsenitis (Fowler's), gtt. j. 
and tinct. opii deodorataa, gtt. ij.-v., every four 
hours. 



ULCERS. 

Martin's elastic bandage is an excellent meas- 
ure in chronic cases. 



A solution presented at the Bublin Pharma- 
ceutical Conference was prepared by shaking 
tincture of iodine with a piece of fused potash 



pbescribkr's memoranda. 275 

until the color was removed, and covering the 
iodoform produced by the addition of eau de 
Cologne or lavender water. Lint dipped in this 
solution, and afterward dried, proved a pleasant 
and efficacious application for indolent sores. 



Dr. Keyes recommends the following in 
syphilitic ulceration : 

Ung. hydrarg. nitratis, diluted one-half ; or, 

I£ . Hydrarg. iodid gr. xx.-xl. 

Vaseline 33. 

M. External use. 



In Sluggish Sores. 

^ Chloral hydrate gr. v.-xx. 

Aquae gjj. 

M. Ft. lotio. Keyes. 



M. Vidal made hi3 first experiments with 
pyrogallic acid in psoriasis in June, 1878, and 
has since employed it with success in the treat- 
ment of venereal ulcers. A man was inocu- 
lated with the matter of his soft chancre at two 
places on the abdomen. Phagedena attacked 
the punctures, as well as the original sore. The 
sore on the penis became as large as a franc, 
that of the right side of the abdomen increased 
to the size of a five-franc piece, and that of the 



276 prescriber's memoranda. 

left side of the abdomen to the size of a two- 
franc piece. Under repeated cauterization with 
sulphate of copper the ulcers improved for a 
time, but again relapsed. At the end of a month, 
M. Vidal made use of an ointment composed of 
one part of pyrogallic acid to five parts of 
vaseline. Three applications were made during 
three successive days. The pain was moderate, 
and lasted only from eight to ten minutes. 
The sores then decidedly improved, and after 
three more applications healing rapidly took 
place. Subsequently, M. Vidal used the same 
ointment for ordinary chancres, and in two 
cases rapid and complete cure followed the third 
application. Once the pure acid was applied, 
but was no more effective, perhaps even less so, 
than the ointment. In cne case, auto-inocula- 
tion on the third day, after a third application 
of the ointment, gave a negative result. 



UTERUS, Diseases of the. 

Dr. Dabney has used the following with great 
success in cervical metritis : 

^ . Ergotine gr. xx. 

Iodine fl. 3 j. 

Glycerine q. s. ad. n.-J j- 

M. Apply twice daily with camel's hair 
brush. 



prescriber's memoranda. 277 

In cold weather, suppositories, made as fol- 
lows, are found of most service : 

J£ . Ergotine gr. xx. 

Ext. belladonna gr. ij. 

Cocoa butter q. s. 

M. Make six suppositories, and insert one 
into the vagina nightly, after using hot douche. 



In warm weather, a solution is preferable : 
I?. Ergotine (or Squibb's solid ex- 
tract) 3 ss. 

Ext. belladonna gr. vj. 

Water and glycerine, of each . fl. J iv. 

A pledget of cotton is saturated with this solu- 
tion, and inserted into the vagina at bedtime, 
after the use of the douche. The cotton should 
be removed in the morning. 



Dr. John M. Bennett, of Liverpool, treats 
chronic cervical metritis by injecting the cervix 
with icdine by means of a long-pointed hypoder- 
mic syringe. The solution is composed of 
iodide and bromide of potash, each twenty 
grains ; tincture iodine, one-half drachm ; water, 
two drachms. Three or more punctures are 
made, according to the amount of hyperplastic 



278 prescriber's memoranda. 

tissue to be absorbed. Three operations are 
generally sufficient. Has never known it to 
cause any disturbance, while it has effected 
many cures after other methods have failed. 



Dr. Wallace says : " I have found the following- 
simple arrangement for intra-uterine medication 
answer very well : Cut the end off a flexible 
No. 10 catheter, pass the wire stilette through 
it, and make a knob on the end of it with wax 
and cotton-wool, which will just cover the end 
of the catheter ; then push up the stilette about 
an inch and a half, roll cotton- wool around it, 
and dip it in the solution to be applied (carbolic 
acid and iodine is excellent), and draw it within 
the catheter so that the knob just covers the 
end, give it a bend like a uterine sound, and 
pass it up to the fundus of the uterus ; then 
draw the catheter down the wire. This, of 
course, brings the medicated cotton-wool in con- 
tact with the uterus through its whole length. 
After leaving it in for a minute or two, it can be 
withdrawn. The speculum is not needed. The 
main recommendation of this arrangement is 
that it saves the cost of a 20s. or 25s. instrument, 
an important matter in these times." 



pkescriber's memoranda. 279 

Ulcer 8 of the Neck of the Uterus. 

1} . Glycerine 25 parts. 

Alcohol 12^- parts. 

Creasote (pure) 1 part. 

M. S. — Touch the ulcers twice a day with 
this solution. 

In twenty- eight cases of simple ulcers, twenty- 
six recovered in a week. In seven severer cases, 
all recovered in a little longer time. In two 
cancerous ulcers, no good resulted after forty 
days 7 treatment. The cases were then treated 
by iodoform. These results justify the belief 
that in simple ulcers — not specific — great good 
is obtained by the astringent and antiseptic 
properties of this wash or lotion. 



Dr. Robert Battey gives us the result of 
his observations in the intra -uterine use of 
iodized phenol during the past eight years. He 
combines one part of iodine with four parts of 
carbolic acid. It is applied to the uterus by 
means of slender, elastic hard-rubber probes 
wound with cotton- wool. The effects of the 
solution are regulated : (a) by the size of the 
cotton wrapper ; (b) by the depth to which it is 
carried into the uterus ; (c) by the number of 
probes successively employed ; (d) by the length 
of time the medicated cotton is allowed to 



280 pkesckibeb's memoranda. 

remain in the uterus. The results of treatment 
have been : 1, perfect removal of cervical 
mucus ; 2, freedom from pain due to the local 
anaesthesia produced by the carbolic acid ; 3, 
rapid absorption of iodine into the circulation, 
evidenced by metallic taste in mouth and throat ; 
4, softening and dilatation of the cervix ; 5, 
temporary arrest of leucorrhoea ; G, watery dis- 
charge sometimes bloody ; 7, exfoliation of 
superficial layer of mucous membrane ; 8, heal- 
ing of abrasions ; 9, disappearance of indura- 
tion; 10, permanent arrest of leucorrhoea; 11, 
removal of viilosities without the curette ; 12, 
disappearance of subinvolution ; 13, the menses 
become regular and healthy ; 14, the appetite 
and digestion improve without medicine ; 15, 
so freely is iodine absorbed that alteratives are 
not required ; 16, the form of the cervix and os 
are often completely changed, and assume even 
a virginal type ; 17, stenosis is not observed in 
many cases ; 18, barrenness is overcome. Rapid 
and at the same time satisfactory cure is not 
obtained, nor is it expected of any method of 
treatment known. 



I£. Bismuth, subnit., 

Glycerinae, aa q. s. to make a thick cream. 
Dr. Suesserott recommends gynecologists to 



prescribes' s memoranda. 281 

use this in preference to other applications to 
ulcerations of the os and cervix uteri. He applies 
it through a glass tube, and retains it with a 
pledget of cotton. 

See also Dysmenorrhea, etc. 



URINE, Disorders, etc., of. 
A Novel Urinal. — A physician has lately at- 
tended a lady suffering with a large abscess, 
where the use of a pan for micturition was im- 
possible, and catheterism annoying, when the 
patient herself suggested the following expe- 
dient : she had a large, coarse sponge enclosed 
in an oil-silk bag, and applied to the parts, 
greatly to her comfort. He has since used the 
plan in other cases, with much satisfaction. 



1^ . Acid, benzoic gr. xx. 

Syr. tolutani fl. Z j. 

M. S. — To be given every third hour, largely 
diluted with water, in urasmia. 



Benzoic acid has been found by Dr. Da Costa 
to prevent particularly the accumulation of the 
urinary salts in the blood. In addition to this 
treatment, the patient is thoroughly purged 



282 peescriber's memoranda. 

with croton-oil. He is also given a warm bath, 
or, if he is too weak, a vapor-bath is taken in 
bed, by means of hot bricks wrapped in damp 
towels. In some cases dry cupping over the 
loins does good. 



3 . Scammonii resinse gr* v. 

Potass, bitart gr. xx. 

Zingiberis gr. viij. 

M. S. — To be administered when needed, in 
ursemic coma. Geo. Johnson. 

#. Tinct. ergotse \ x. 

Tinct. f erri perchlor Tf^ v. 

Spts. chlorof ormi TT\_ v. 

Inf us. quassiae ad. § j. 

M. S. — Three times a day, for incontinence in 
the young. 



Rhus aromatica given in five cases of inconti- 
nence of urine in children and young persons ; 
results not nattering ; seemed to benefit in 
three of the cases. 



Retention may be due : 1, to congenital con- 
traction of the meatus, which requires surgi- 
cal enlargement of the orifice ; 2, to phimosis, 
where the preputial orifice is very small ; 3, 



prescreber's memoranda. 283 

to stone in the bladder. It is more difficult to 
find a stone in the bladder when distended with 
urine than when empty. Great care is requisite 
when sounding a child. Incontinence is due : 1, 
to rectal complaints ; 2, to a tight foreskin ; 3, 
to a small congenital meatus ; 4, to calculus 
impacted in the urethra. Causes 3 and 4 are 
usually not sufficiently attended to. Stone im- 
pacted in the urethra may cause retention 
or incontinence, according to its location. A 
stone so impacted does not cause so much 
pain and discomfort as might be imagined. 
Milk dieting and the use of belladonna in noc- 
turnal, and strychnia and iron in diurnal inconti- 
nence, are indicated. Mr. Teevan. 



I£ . Potass, citrat § j. 

Sodae bicarb 3 v. 

Syr. limon J j. 

Aquae ad. § iv. 

M. S. — 3 j. every two hours, to render the 
urine alkaline. Roberts. 

5 • Ext. belladonna fl - 3 j. or ss. 

Ext. buchu fl I j. 

Spts. etheris nitros § ij. 

M. S. — Teaspoonful three or four times a 
day, for dysuria in females. 



284 prescriber's memoranda. 

Tinct. belladonnas, gtt. iv. to x. at bedtime. 
Chloral has been highly recommended by vari- 
ous authors in incontinence. From four to ten 
grains at bedtime, in milk or water. 



I£ . Strychniae gr. j. 

Puly. cantharides gr. ij. 

Morph. snlph. . .".- gr. jss 

Ferri pulv 3 j. 

M. Ft. pil. no. xl. S. — One three times a 
day to a child ten years old. S. D. Gross. 

This prescription will speedily relieve the ir- 
ritability of the bladder, especially if conjoined 
with such means as a cold shower-bath daily, 
the avoidance of irritant food and late suppers, 
the patient lying on the side or belly, and tak- 
ing care to drink nothing for a few hours 
preceding sleep, arid to empty the bladder on 
going to bed. 

Some recent British writers state that, after 
numerous failures with all orthodox modes of 
treatment, it was found that cutting off meat 
in the diet was sufficient, in many cases, to 
effect a rapid and permanent cure in enuresis 
in children. 



presckibek's memoranda. 285 

VAGINA. 

M. Gallard states that he constantly recom- 
mends for vaginismus the gradual dilatation of 
the vagina by tents of progressively increasing 
size. According to the circumstances of the 
case, he impregnates these tents with different 
applications. He also believes that these topi- 
cal applications aid materially in curing vagi- 
nismus. For this purpose M. Gallard recom. 
mends the use of iodoform made up into an 
ointment (iodoform, cocoa butter, and fresh 
lard, equal parts). This preparation may be 
employed when there is rudeness or excoriation 
of the mucous membrane. If there is only 
pain, without any visible change in the mu- 
cous membrane, extract of belladonna, one 
part, and fresh lard, seven and a half parts, 
may be prescribed. In this, as in the previous 
case, the tents may be as small as possible. 
After the employment of the iodoform ointment 
it is well to replace it after a few days, when 
the redness and excoriations have disappeared, 
by the belladonna preparation. In both cases 
care should be taken to increase daily, by an 
imperceptible but still advancing gradation, the 
size of the tent. By this means, at no very dis- 
tant period, a tent is habitually employed 



286 prescriber's memoranda. 

which is of such a size as to allow the introduc- 
tion of the male organ. In effecting this result 
the action of the narcotic substance and the 
progressive dilatation have both materially as- 
sisted each other. 



The following has been recommended for 
vaginismus : 

I£ . Olei theobromae 3 j. 

Potass, bromid gr. x. 

Ext. belladonnas gr. vj. 

Acid, thymic. gr. j. 

M. Fiat in suppositor. no. j. To be placed 
in the vagina every evening. 



1^ . Potass, permanganat gr. xx. 

Potass, chlorat 3 iv. 

Aquae O ij. 

M. S. — Teaspoonful to be added to a quart 
of warm water, and used as a vaginal injection, 
night and morning, in soreness of the vagina. 



Non-specific and acute cases of vaginitis Dr. 
Goodsell treats by such hot and emollient injec- 
tions as flaxseed, or slippery-elm bark tea, to 



erescribek's memoranda. 287 

which laudanum has been added ; the solution 
which he usually employs contains laudanum 
fl. | ij. to Oij. of flaxseed. When the inflam- 
mation has subsided, vaginal suppositories, con- 
taining five grains of iodoform, are ordered 
twice or thrice daily. In the chronic forms of 
this complaint, suppositories of tannin or of 
iodoform, or long tampons of absorbent cotton, 
are employed, which have been dipped in as- 
tringent solutions of acetate of lead and zinc, 
to which laudanum has been added. 



VERTIGO. 

In vertigo of gastric origin, the best results 
are obtained by the use of alkalies and bitter 
tonics. Most cases are decidedly benefited by 
the use of Vichy or Carlsbad waters, or by the 
bicarbonate of sodium after meals. The gen- 
eral tone of the system is invigorated by tonics 
before meals. Late in the course of the disease 
iron is given thrice daily in combination with 
one-thirtieth of a grain of strychnia. Another 
plan of treatment consists of the administra- 
tion of small doses of corrosive sublimate, while 
paying strict attention to the bowels and diet. 



288 pbescribek's memoranda. 

VOMITING. 

Half a drachm of bromohydric acid in an 
ounce of water, four times a day, is % said to 
arrest the vomiting" attendant on ulcer of the 
stomach, and to enable the retention of solid 
food. It is possible that this remedy may prove 
of good service in controlling nausea from other 
causes. 

Dr. Wm. Boys says : " I have given sulphate of 
atropia in vomiting of pregnancy for years, and 
do not know of any case but what it afforded 
prompt relief. I give it after a formula recom- 
mended in the London Lancet, for the sweating 
of phthisis : 

3£ . Atropise sulph gr. j. 

Morphias sulph gr. iv. 

Acid, sulph. arom 3 iij- 

Aquae 3 v. 

M. S. — Ten to twenty drops three times a 
day." 



Dilatation of the cervical canal for the vomit- 
ing of pregnancy is now regarded as not only an 
efficient means of treatment, but reasonably 
safe. The dilatation should not, however, be 
carried to the interior of the uterine cavity, but 



prescribeb's memoranda. 289 

should rather be confined to the lower portion 
of the constricted part of the cervical canal, 
and even here need not be extensive. It may- 
be accomplished with the index finger, which 
should be gently carried through the external 
os with the rotating movement, until one-half 
of the first phalanx has been introduced. This 
may be easily accomplished with the multipara, 
but with the primipara it will generally be neces- 
sary to enlarge the os by previous dilatation, until 
room enough has been gained to admit the 
finger. The statistics of this method of treat- 
ment are not sufficiently large to warrant us in 
saying that it is wholly unattended with danger 
of abortion ; but from records of several cases, 
since 1875, it may be said that it is a safe and 
sure remedy. It was discovered by Copman in 
1875, when he dilated for the purpose of produ- 
cing an abortion for the relief of vomiting, and 
instead of causing the abortion, he cured th 
vomiting. 



A writer relates, in the Louisville Medica* 
News, a case of incessant diarrhoea and morn- 
ing sickness cured by bromide of potassium. 
The patient had suffered during all her previ- 
ous pregnancies with this trouble, which lasted 
from the third month up to the time of deliv- 
19 



290 pkescbibeb's memokanda. 

ery. As all the remedies used for vomiting 
in pregnancy remained without effect, fit was 
thought that both the diarrhoea and vomiting 
were due to reflex irritation. He at once 
gave her twenty-five grain doses of bromide 
of potassium three times a day, the first dose 
half an hour before rising. As long as she con- 
tinued taking the medicine, the trouble did not 
return ; but so soon as she attempted to leave it 
off for a whole day, diarrhoea again set in. After 
the first week she was able to ward off all the 
symptoms with only one dose in twenty-four 
hours, half an hour before rising. During her 
next pregnancy, when again suffering from the 
old troubles, the same treatment was reverted 
to, and with the same success. 



Lubelsky has given almost immediate relief, 
in the vomiting of pregnancy, by spraying ether 
over the epigastric region and corresponding 
portion of the spinal column. Continue for 
three to five minutes, and repeat every three 
hours. 



At a recent meeting of the British Medical 
Association, Dr. Edwyn Andrew called attention 
to a new method of using ice. He thought that 
the effects of the cold could be supplemented 



prescriber's memoranda. 201 

by combining with the ice during the process of 
freezing the active principles of drugs. In this 
manner ice may be rendered highly antiseptic, 
caustic, or styptic. In diseases of the throat and 
stomach, and in hemorrhage from the internal 
organs, ice might be pleasantly used to relieve 
symptoms, and at the same time to convey medi- 
cine or food to the stomach, when the latter 
would not retain them in any other way. 



^ . Cerii oxalat gr. j. 

Ipecacuanhas gr. j. 

Creasoti gtt. ij. 

M. S. — To be taken every hour, in vomiting 
of pregnancy. Goodell. 

J$ . Cerii oxalatis gr. xxiv. 

Ext. hyoscyami gr. xxxvj. 

M. et ft. pil. no. xij. Take one twice a day, 
in the vomiting of pregnancy. 



$ . Chloral hydratis gr. x v.-xx. 

Milk §ij. 

Yolk of an egg j. 

Beat up well, warm, and inject into rectum. 
For reflex vomiting of pregnancy. Kane. 



292 prescriber's memoranda. 

For Vomiting following the Use of Opium. 

5 . Potio Riverius § v. 

Morph. sulph gr. j. 

Syr. aurantii, 

Salep aa § j. 

M. S. — Teaspoonful doses. C. H. Avery. 



To prevent the nausea and vomiting secondary 
to the use of opium, combine the drug with 
bromide of potassium. 

I£. Sol. morph. (U. S. P.) § j. 

Potass, bromid 3 j- 

M. S. — Teaspoonful doses. Metcalfe. 



WARTS. 

A writer in the British Medical Journal has 
successfully removed venereal warts by powder- 
ing over the surface twice daily with equal parts 
of burnt alum and tannin. As these growths 
occur chiefly in situations where mucous and 
skin surfaces are in contact and moist, this plan 
suggested itself. In the first case in which he 
applied it the warts were easily rubbed off in 



prescriber's memoranda. 293 

the course of three or four days, and other cases 
have given equally good results. 



Warts are to be removed by means of the der- 
mal curette, as has been advised in Vienna. 
This spoon-shaped instrument must be tolerably 
sharp, and by a careful kind of cutting move- 
ment around the wart it may be removed bodily, 
leaving a slightly depressed surface, which bleeds 
a little ; as this heals, perfect epidermis is formed, 
with no scar, and the wart generally remains 
absent. The little operation is hardly at all 
painful. 



WICKERSHEIMER'S FLUID. 

For preserving animal substances, pathologi- 
cal specimens, etc. 

For injecting. ^j™" 

1J. Arsenious acid. 16 grms. [ 3 iv.] 12grms. 

Sodium chlor . . 80 grms. 60 grms. 

Potass, sulph. 200 grms. 150 grms. 

Potass, nitrate. 25 grms. 18 grms. 

Potass, carb. . . 20 grms. 15 grms. 

Water 10 litres [qts.10^4-] 10 litres. 

Glycerine 4 litres. 4 litres. 

Wood-naphtha, f litre. f litre. 



294: prescriber's memoranda. 

WHOOPING-COUGH. 

]£. Acid, nitric, dil fl. 3 j. 

Syr. pruni Virg fl. § ss. 

Aquas q. s. ad. fl. § ij. 

M. Dose, a teaspoonful. 

3 . Potass, bromid 3 jss. 

Aquae 3]. 

M. Spray for whooping-cough. 



Dr. B. F. Dawson recommends the local ap- 
plication of a solution of sulphate of quinia to 
the fauces. 



M. Dervieux believes he has found a preserva- 
tive means in aconite associated with ipecac and 
cherry-laurel water. This mixture is either a 
veritable preventive, or simply an abortive. 
His formula is as follows : 

I£. Ext. of aconite. . .05 grm.=f gr. nearly. 
Ch. -laurel water. 4 grm.— 1 dr. nearly. 
Syr. of ipecac. . . 3 grm. =| dr. nearly. 
Mucilage 200 grm. =6^ oz. nearly. 

This is given, as soon as the characteristic 
cough- presents itself, in doses of a teaspoonful 



fresckiber's memoranda. 295 

every hour to young infants ; two teaspoonfuls 
to those more than three years of age, and a 
teaspoonful to adults every hour. 



In pertussis, Dr. Pollack, of Austria, recom- 
mends, for insufflation : 

J£. Quinias tannat, 

Sodae bicarb aa 5 parts. 

Pulv. acacia? 100 parts. 

M. Use with an insufflator. 



Dr. Hildebrandt is an advocate of petroleum 
in the treatment of pertussis. His mode of 
employment could not be simpler. Small bits 
of rags are dipped into it and placed beneath 
the pillow of the patient, or are suspended on 
wooden hooks at the head of the bed. This 
method is as simple as economical. 



I£. Pulverized belladonna.. 1 grm. (15 grs.). 

Oxide of zinc 1 grm. (15 grs.). 

Extract of wild thyme. . 2 grm. ( 3 ss.). 
Mix and divide into 40 pills. S. — From one to 
six per day. Bouchet. 



A writer in the Medical Record extols the 
vapor of cresoline as wonderfully beneficial in 
whooping-cough. Forty-eight hours after the 



296 prescriber's memoranda. 

vaporizers were started the paroxysms ceased 
and did not return. His observations of this 
remedy were limited to its use in the u Shelter- 
ing Arms Nursery," where the children were 
exposed to the vapor continuously, and under 
favorable surroundings. 



Mr. Arthur Wigles worth began, over four 
years ago, to treat all cases of whooping-cough 
solely with the sulphate of atropia, from 
infants two months old to the adult. It re- 
quired some little time to find out the average 
dose to begin with; but he now begins with 
T |o of a grain (or one minim in a drachm of 
water), in children from one to four years of 
age, either diminishing or increasing the dose 
as occasion dictates ; and, except in very 
severe cases, only order it to be given once a 
day ; but when the nightly paroxysms are very 
severe, he orders half the dose to be repeated 
an hour before bedtime. 

The results that follow its administration may 
be summed up thus : 1st. There is steady di- 
minution in the number of paroxysms. 2d. 
There is a diminution in the duration of the 
paroxysms. 3d. There is a change in the char- 
acter of the "whoop," as if the vocal cords 
were not so closely approximated. Further, 



pkesceibek's memoranda. 297 

if the atropine is withheld the beneficial effects 
derived from it subside. 



Dr. J. Lewis Smith speaks very highly of the 
beneficial effect of inhalation of carbolized vapor 
in whooping"- cough. The following is the pre- 
scription, used with the steam atomizer : 

I£ . Acid, carbolic 3 ss. 

Potass, chlorat 3 ij. 

Glycerinse 3 ij. 

Aquae 3 vj. 

M. To be used three times daily. 
He details a series of cases (not, however, very 
numerous) in which this treatment seemed to 
have a very decided effect in subduing the 
tendency to spasmodic cough, as well as the 
severity of the paroxysms. 



Dr. George Baylis reports ten cases successfully 
treated by him with the nitrate of amyl. Its 
combination with carbolic acid in the following 
formula, and given by a steam atomizer, has 
perhaps proved the most beneficial : 

I£ . Amyl nitrite 3 ss. 

Acid, carbolic gtt. x. 

Glycerine, 

Alcohol aa 3 ss. 

31. S. — Use by inhalation with the steam 



298 prescriber's memoranda. 

atomizer whenever the paroxysm is felt coming 
on. 

The inconvenience of this method of adminis- 
tration will, however, deter many from using it. 
In such cases the nitrite may simply be com- 
bined with alcohol and the carbolic acid and a 
few drops poured into a tea-cup or on a hand- 
kerchief and inhaled, while from one-half to 
two drops may be given upon a lump of sugar 
of the pure amyl nitrite, internally, every three 
or four hours. I have found this course of 
treatment in the majority of uncomplicated 
cases to give prompt relief to the little sufferers, 
and have a decided effect in shortening the 
course of the disease. Its use in controlling 
convulsions, especially those occurring in in- 
fants, I have found most decided. I do not 
consider it curative, but it possesses the power 
of controlling the spasms until curative remedies 
can be administered and have time to act. 
Colic, so frequently met with in young children, 
is generally aborted by the inhalation of this 
salt, giving almost immediate relief, followed 
shortly by a quiet sleep. 



In 1863, Prof. C. Binz, recommended for this 
obstinate complaint a solution of quinine and tan- 
nic acid ; and Dr. C. F. Swan states that he has 



pbesckibek's memoeanda. 299 

adopted this remedy with great success in many 
cases of whooping-cough. The formula consists 
of a solution of quinine and tannic acid, 4 grins, 
of the former to 1 grm. of the latter, in water, 
syrup, licorice, etc. ; and it is to the local action 
of the quinine upon the fauces and glottis, as 
well as to its antispasmodic virtues, that the 
favorable results are attributed. Of 40 cases 
of whooping-cough in which this remedy was 
used, 3 were so mild as to require little or no 
treatment. No record is given in 6 cases ; and 
G children refused the medicine in consequence 
of its bitter taste. Two died of spasm of glottis 
marasmus respectively. Deducting the 17 cases 
from the 40, we find 23 left. Of these 23, 3 
received no benefit, and 2 but little benefit from 
the quinine and tannin. But, in the case of the 
15 'patients not heretofore considered, the disease 
was completely aboi'ted in an average period of 
3.8 day 8, 3 of the cases being complicated by 
pneumonia, and 2 by capillary bronchitis. 



Sir Wm. GuWs Cough Mixture, said to be 
good in whooping-cough : 
$ . Olei morrhuas, 

Honey, 

Lemon juice aa equal parts. 

M. Dose, 3j.-3ij. 



300 prescriber's memoranda. 

Dr. P. Brynberg Porter treated a large num- 
ber of cases of this disease with small doses of 
chloral, gr. iij.-viij. every four hours, with good 
success. 



WORMS. 

fy . Fl. ext. spigelias § j. 

Fl. ext. sennae § ss. 

M. S. — Ateaspoonful to a child of three to 
five years ; or 

I£ . Fl. ext. spigelise et sennas § J- 

Santonini gr. vii j. 

M. S. — Teaspoonful to a child of five. 

J. L. Smith. 
For the expulsion of the round worm no bet- 
ter formulae than these have been devised. 
They are found an effectual means also of de- 
stroying the ascaris vermicularis. 



Ijfc . Epsom salts 2 ounces. 

Common salt \ ounce. 

M. S. — Give two tablespoonfuls in a half -glass 
of water, with five drops carbolic acid, night 
and morning, for ascarides. 

The salt and carbolic acid will destroy the 
worms, and the brisk action of the salts will 
carry them out. Persevere. Barkley. 



prescriber's memoranda. 301 

WOUNDS. 

Dr. Millet, a French army surgeon, recom- 
mends powdered aloes as a dressing for wounds, 
both as a means of favoring cicatrization and for 
closing them. It is said to relieve the severe 
pain of wounds almost immediately, and re- 
quires to be removed only at long intervals. 



5 . Acid, tannic § ij. 

Alcoholis absolut fl. § ss. 

Athens fl. § ijss. 

Collodion q. s. ad. fl. § xij. 

M. Styptic colloid. 

3. Collodion fl. I j. 

Olei ricini, 

Acid, carbolic aa fl. 3 ss. 

M. Carbolized collodion. 



